Can Team Triage Improve Patient Flow in the Emergency Department? A Systematic Review and Meta-Analysis

Area of Science:

• Emergency Medicine
• Healthcare Management
• Clinical Triage

Background:

• Emergency departments (EDs) globally face overcrowding challenges.
• Current triage systems often rely on single-nurse assessments.
• Improving patient flow and reducing wait times are critical ED objectives.

Purpose of the Study:

• To conduct a feasibility study for revamping ED triage services.
• To evaluate the impact of ED team triage versus single-nurse triage on patient flow.
• To synthesize evidence from randomized controlled trials (RCTs) on ED triage effectiveness.

Main Methods:

• Systematic review and meta-analysis adhering to Cochrane methodology.
• Searched for RCTs comparing team triage with single-nurse triage.
• Assessed risk of bias using GRADE criteria and extracted data on length of stay (LOS) and wait time (WT).

Main Results:

• Four cluster RCTs involving 14,772 patients met inclusion criteria.
• No statistically significant or clinically relevant reduction in LOS or WT was observed for team triage.
• One study indicated a potential reduction in mortality with team triage (RR 0.34).

Conclusions:

• Current RCT evidence does not conclusively support team triage for improving ED patient flow.
• Team triage may offer benefits in reducing mortality, warranting further investigation.
• Nursing managers should consider staff morale, economic, and organizational factors when implementing team triage.