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Robustness and Effectiveness of the Triage System in the Pediatric Context
Marcello Montefiori1, Enrico di Bella2, Lucia Leporatti3
1Department of Economics, University of Genoa, Via Vivaldi 5, 16126, Genoa, Italy. montefiori@unige.it.
Insights
The pediatric triage system effectively prioritizes urgent cases, ensuring timely care. However, non-urgent patient wait times in emergency departments (EDs) are influenced by patient flow and staffing levels.
Area of Science:
- Pediatric Emergency Medicine
- Healthcare Management
- Triage Systems
Background:
- Increasing emergency department (ED) utilization impacts healthcare quality.
- Evaluating triage system performance in pediatric settings is crucial due to waiting time effects on acute patient care.
Purpose of the Study:
- Assess the effectiveness and robustness of a pediatric triage code system.
- Identify determinants of waiting times for urgent and non-urgent pediatric patients.
Main Methods:
- Survival analysis of 37,767 pediatric ED visits in an Italian hospital (2015).
- Analysis of patient numbers, waiting times, and supply-side variables like staff shortages.
Main Results:
- Urgent patients' wait times to physician assessment were generally under 15 minutes, unaffected by non-urgent patient volume.
- Non-urgent patient wait times were significantly impacted by ED flow, staff shortages, and non-clinical factors (age, nationality).
Conclusions:
- The triage system demonstrates effectiveness and safety for urgent pediatric patients.
- Current ED organization successfully prioritizes acutely ill children, meeting its primary healthcare objective.
Background:
The increasing use of emergency departments (EDs) potentially compromises their effectiveness and quality. The evaluation of the performance of the triage code system in a pediatric context is important because waiting time affects the quality of care for acutely ill patients.
Objective:
In this study, we aimed to assess the effectiveness and robustness of the triage code system in a pediatric context and identify the determinants of waiting times for urgent and non-urgent patients.
Methods:
Data regarding 37,767 pediatric patients who accessed the ED of a major Italian pediatric hospital in 2015 were investigated in order to study patient numbers and waiting times. The determinants of waiting times for urgent and non-urgent patients, as well as variables referring to the "supply side," such as periods of staff shortage, were analyzed using a survival analysis framework.
Results:
For urgent patients, the waiting time between triage and the first physician assessment is generally below the standard threshold of 15 min and this is not affected by the number of non-urgent patients waiting for care. Conversely, the waiting time for non-urgent patients is affected by ED flow, periods of staff shortage, and non-clinical variables (age and nationality).
Conclusion:
Our results suggest that the triage level assignation system is effective in terms of safety for urgent patients. The current ED organization adequately fulfills its primary goal of providing healthcare for acutely ill patients.
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