[Introducing triage-initiated imaging examinations at a Hungarian emergency department]

Triage is fundamental to emergency department operations and patient safety. Extended triage models, in which professionals can also initiate laboratory and imaging tests, are increasingly adopted. However, the expanded scope of practice may increase psychological and physical stress on triage nurses.

The aim of our work is to develop the methodological framework for the introduction of triage-initiated imaging examinations at a Hungarian emergency department, to establish the basis for patient safety monitoring, and to map the facilitating and impeding factors of implementation, including the workload of triage professionals.

We supplemented our institution's system with strictly defined imaging test ordering. A validated questionnaire was used to identify facilitators and barriers to routine adoption. Performance will be analyzed using predetermined indicators (triage time, patients per shift, imaging tests ordered), with monthly data review guiding organizational adjustments. The Plan-Do-Check-Act method will be applied to monitor physical and psychological stress factors and identify critical periods.

The indication list for triage-initiated imaging, the radiation safety and basic imaging training curriculum with a final test, and the cyclical quality improvement project plan with audit milestones were developed.

Literature data support the positive impact of triage-initiated imaging on patient pathways and patient satisfaction. Through regular monitoring of triage nurse workload, we are developing a quality improvement project at the intersection of patient safety and provider well-being. We believe that a pragmatic approach provides practical support for sustainable and safe emergency operations. Orv Hetil. 2026; 167(34): 1359-1364.