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Getting to the Heart of the Matter: A Triage Model to Improve Utilization of Cardiology Consultative Services

Joseph K Agor1, Mustafa Y Sir2, Kalyan S Pasupathy2

  • 1School of Mechanical, Industrial, and Manufacturing Engineering, Oregon State University, Corvallis.

Mayo Clinic Proceedings. Innovations, Quality & Outcomes
|January 30, 2020
PubMed

Insights

Implementing an emergency department (ED) referral triage system significantly reduced cardiology appointments and no-show rates. This system improved efficiency without negatively impacting patient return visits, hospitalizations, or cardiovascular testing.

Area of Science:

  • Cardiology
  • Healthcare Management
  • Health Services Research

Background:

  • Emergency department (ED) referrals often lead to high utilization of outpatient cardiology services.
  • Inefficient referral systems can result in increased appointment no-shows and resource strain.

Purpose of the Study:

  • To evaluate the effectiveness of a triage system for emergency department (ED) referrals to outpatient cardiology clinics.
  • To assess the impact of this triage on appointment utilization, no-show rates, and patient outcomes.

Main Methods:

  • A retrospective study comparing pre- and post-triage implementation cohorts (303 and 267 patients, respectively).
  • Analysis of billing data to track ED return visits, hospitalizations, cardiology appointments, and cardiovascular testing.
  • Triage focused on patients with cardiovascular complaints deemed safe for outpatient follow-up.

Main Results:

  • The triage system reduced cardiology appointments by 73.0%.
  • The appointment no-show rate decreased from 17.8% to 7.9%.
  • No significant increase in ED return visits, hospitalizations, or cardiovascular testing was observed.

Conclusions:

  • Triage of ED referrals effectively reduces outpatient cardiology appointment utilization.
  • The implemented triage system demonstrated improved efficiency without compromising patient safety or increasing healthcare resource use.
Abstract

Keywords:
CV, cardiovascularED, emergency department

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