No relationship between emergency department activity and triage categorization

Area of Science:

• Emergency Medicine
• Healthcare Operations
• Clinical Triage Systems

Background:

• The Australasian National Triage Scale (NTS) is widely used in emergency departments (EDs) to prioritize patient care.
• Understanding the consistency of NTS categorization is crucial for effective resource allocation and patient flow management.
• Previous studies have not definitively established NTS consistency in relation to ED activity levels.

Purpose of the Study:

• To evaluate the consistency of Australasian National Triage Scale (NTS) categorization in a large Australian hospital ED.
• To determine if NTS categorization varies significantly with daily patient presentation volumes ('busy' vs. 'nonbusy' days).
• To assess the long-term consistency of NTS categorization over a 2-year study period.

Main Methods:

• A prospective, observational study was conducted in a large Australian adult ED.
• Data on NTS category, patient features, and disposition were collected for 94,681 presentations over 2 years.
• Admission rates were analyzed based on NTS category, comparing 'busy' (defined by presentation thresholds) and 'nonbusy' days.

Main Results:

• No statistically significant differences in admission rates were found between 'busy' and 'nonbusy' weekdays or weekend days across NTS categories.
• Admission rates showed variations based on the time of day and patient age but remained consistent over the 2-year study.
• The study found high admission rates for higher NTS categories (e.g., 93.2% for category 1 on busy weekdays).

Conclusions:

• Triage categorization using the Australasian NTS is consistent and does not appear to be influenced by daily ED activity levels in this setting.
• The NTS has demonstrated consistent performance over time in this large Australian ED.
• Further research in diverse clinical settings is recommended to explore potential variations related to specific patient populations.