Triage quality control is missing tools-a new observation technique for ED quality improvement

Area of Science:

• Emergency Medicine
• Healthcare Quality Improvement
• Patient Safety

Background:

• Accurate patient urgency assessment is vital for emergency department (ED) safety.
• Existing triage quality control methods require significant resources.
• A need exists for a less laborious triage quality control technique.

Purpose of the Study:

• To introduce and evaluate an observation technique for identifying patients at risk of erroneous triage assessments.
• To assess the technique's potential for improving triage performance and patient safety.
• To determine if the technique is less laborious than current quality control methods.

Main Methods:

• A novel observation technique was developed to identify potential triage errors.
• Data was collected using nurse-completed survey forms.
• The study involved consecutive adult patients in a hospital ED over two periods (14 days in 2010 and 4 days in 2012).

Main Results:

• The observation technique successfully identified patient groups at risk for erroneous triage.
• Under-triage was most common in patients presenting with chest pain, shortness of breath, collapse, stomach pain, and infections.
• Injuries and musculoskeletal symptoms were less frequently under-triaged despite their prevalence.

Conclusions:

• Emergency departments can effectively monitor triage quality using this simple observation technique.
• The technique demonstrated good usability and contributed to improving the triage quality process.
• This method offers a practical approach to enhancing patient safety in EDs.