Implementation of a Pediatric Emergency Triage System in Xiamen, China
Gang-Xi Lin1, Yin-Ling Yang2, Denise Kudirka3
1Department of Pediatrics, Southern Medical University, Guangzhou, Guangdong 510515; Department of Pediatric Emergency Medicine, First Affiliated Hospital of Xiamen University, Xiamen, Fujian 361003, China.
Insights
The new Chinese pediatric emergency triage system (CPETS) significantly improved patient care by reducing wait times and increasing triage accuracy. This enhanced system led to better efficiency in pediatric emergency rooms.
Area of Science:
- Emergency Medicine
- Healthcare Systems Analysis
- Pediatric Care
Background:
- Chinese pediatric emergency rooms (PERs) face overcrowding due to limited community healthcare access.
- A new five-level Chinese Pediatric Emergency Triage System (CPETS) was developed, modeled after the Canadian Triage System and Acuity Scale.
Purpose of the Study:
- To evaluate the clinical value and effectiveness of the CPETS in a Chinese hospital setting.
- To compare the outcomes of the CPETS with the previous two-level triage system.
Main Methods:
- A comparative study design was used, analyzing data from before (control group) and after (experimental group) CPETS implementation.
- Key metrics including patient flow, triage rates, triage accuracy, wait times (overall and for severe cases), and patient/family satisfaction were assessed.
Main Results:
- CPETS implementation led to reduced patient flow, higher triage rates (93.40%), and improved triage accuracy (96.32%).
- Wait times were significantly shorter for all patients (37.30 min vs. 41.60 min) and especially for severe cases (2.07 min vs. 3.23 min).
- Family satisfaction rates increased to 94.23% with the CPETS.
Conclusions:
- The CPETS enhances nurses' triage capabilities, enabling faster treatment for severe pediatric cases.
- The system effectively redirects non-urgent patients, improving overall PER healthcare delivery efficiency.
Background:
Pediatric emergency rooms (PERs) in Chinese hospitals are perpetually full of sick and injured children because of the lack of sufficiently developed community hospitals and low access to family physicians. The aim of this study was to evaluate the clinical value of a new five-level Chinese pediatric emergency triage system (CPETS), modeled after the Canadian Triage System and Acuity Scale.
Methods:
In this study, we compared CPETS outcomes in our PER relative to those of the prior two-level system. Patients who visited our PER before (January 2013-June 2013) and after (January 2014-June 2014) the CPETS was implemented served as the control and experimental group, respectively. Patient flow, triage rates, triage accuracy, wait times (overall and for severe patients), and patient/family satisfaction were compared between the two groups.
Results:
Relative to the performance of the former system experienced by the control group, the CPETS experienced by the experimental group was associated with a reduced patient flow through the PER (Cox-Stuart test, t = 0, P < 0.05), a higher triage rate (93.40% vs. 90.75%; χ2 = 801.546, P < 0.001), better triage accuracy (96.32% vs. 85.09%; χ2 = 710.904, P < 0.001), shorter overall wait times (37.30 ± 13.80 min vs. 41.60 ± 15.40 min; t = 11.27, P < 0.001), markedly shorter wait times for severe patients (2.07 [0.65, 4.11] min vs. 3.23 [1.90,4.36] min; z = -2.057, P = 0.040), and higher family satisfaction rates (94.23% vs. 92.21%; χ2 = 321.528, P < 0.001).
Conclusions:
Implementing the CPETS improved nurses' abilities to triage severe patients and, thus, to deliver the urgent treatments more quickly. The system shunted nonurgent patients to outpatient care effectively, resulting in improved efficiency of PER health-care delivery.
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