Novel IT Application for Reverse Triage Selection: A Pilot Study

The objective of this study was to develop and evaluate an evidence-based information technology (IT) application that guides clinical decision-making during the reverse-triage selection process in mass casualty incidents.

Based upon 28 validated critical interventions (CI) relevant for determining whether a patient qualifies for early discharge, we developed the Reverse Triage Tool of Leuven (RTTL). The RTTL is compatible with the health electronic record (HER) of UZ Leuven, a tertiary hospital in Belgium. During a 3-week period in March 2015, we registered data from 2 groups of patients: a random group (no RTTL usage) and a filtered group (RTTL usage).

When applying the original 28 CIs, we were able to select almost twice as many patients in the filtered group who qualified for early discharge compared with patients in the random group. The predictive validity was highly satisfactory.

The RTTL saves time in 2 ways. First, it reduces the patient population that needs to be evaluated for potential early discharge to one-third. Second, it doubles the probability of selecting an actual dischargeable patient. Each selected patient, however, still must undergo multidisciplinary reassessment in order to qualify for early discharge. Thus, further research is required to optimize the IT application.(Disaster Med Public Health Preparedness. 2018;12:599-605).