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Effectiveness of a Training Course on Accuracy of Triaging of Pediatric Patients
Mona A Azzam1, Enas F Elngar1, Ayman A Gobarah1
1Pediatric Department, Faculty of Medicine Suez Canal University, Ismailia, Egypt.
Insights
Pediatric triage accuracy significantly improved after a training course, reducing critical patient delays. Further enhancements can be achieved through ongoing education and feedback.
Area of Science:
- Emergency Medicine
- Pediatric Care
- Healthcare Quality Improvement
Background:
- Accurate pediatric triage is crucial in busy emergency departments to prevent delays in critical care.
- The Canadian Triage and Acuity Scale (PaedCTAS) was implemented but challenges remained in prioritizing critical pediatric patients.
Purpose of the Study:
- To evaluate the effectiveness of a specialized training course on the accuracy of pediatric patient triage.
- To assess if improved triage accuracy leads to better patient prioritization and timely management.
Main Methods:
- A triage training course was delivered to healthcare professionals over two months.
- Patient encounter sheets were retrospectively reviewed for 6 months pre-training and 12 months post-training.
- Triage accuracy was determined by comparing assigned levels to those set by pediatric emergency physicians and by analyzing admission rates.
Main Results:
- A total of 31,053 patient encounters were analyzed.
- Triage accuracy improved significantly, increasing from 56.5%-78.3% pre-course to 79.1%-90.8% post-course.
- The primary remaining errors were instances of down-triage, indicating patients were assigned a less urgent level than appropriate.
Conclusions:
- The implemented triage training course demonstrated a significant positive impact on the accuracy of pediatric patient triage.
- Recommendations for sustained improvement include repeated training sessions and incorporating direct feedback and debriefing on triage challenges.
Background:
In the context of a new but busy Pediatric Emergency Department, the risk of missing patients who need more emergent care can be reduced by timely and accurate triaging. In the emergency department of King Fahad Armed Forces Hospital, the Canadian Triage and Acuity Scale had already been implemented, including the pediatric version (PaedCTAS). However, a common observation remained that critical patients did not always receive priority with subsequent delays in management. To improve this accuracy, a training course was administered to health care professionals responsible for triaging of pediatric patients.
Aim:
To determine the effectiveness of a training course on accuracy of triaging of Pediatric Patients.
Methods:
A triage training course was conducted over two months, with patient encounter sheets reviewed before the course for 6 months and after the course for 12 months. Accuracy was calculated by comparing it to level as determined by two pediatric emergency physicians. Also, admission rates were used as a surrogate marker to also determine accuracy.
Results:
A total of 31 053 patient sheets were reviewed. There was a considerable improvement in the correct determination of all triage levels, with accuracy ranging from 56.5% to 78.3% before the course, and reaching from 79.1% to 90.8% after the course with a statistically significant difference. Triaging errors still present were mainly in the form of down-triage.
Conclusion:
Our training course in triage has a significant impact on the accuracy of triaging of ill pediatric patients. Further improvement can be obtained by repeated courses and direct feedback with debriefing sessions on challenges to triage level determination.
