Back to Search
Start Over
Emergency department provider in triage: assessing site‐specific rationale, operational feasibility, and financial impact
- Source :
- Journal of the American College of Emergency Physicians Open, Journal of the American College of Emergency Physicians Open, Vol 2, Iss 3, Pp n/a-n/a (2021)
- Publication Year :
- 2021
- Publisher :
- John Wiley and Sons Inc., 2021.
-
Abstract
- Emergency department (ED) crowding is recognized as a critical threat to patient safety, while sub‐optimal ED patient flow also contributes to reduced patient satisfaction and efficiency of care. Provider in triage (PIT) programs—which typically involve, at a minimum, a physician or advanced practice provider conducting an initial screening exam and potentially initiating treatment and diagnostic testing at the time of triage—are frequently endorsed as a mechanism to reduce ED length of stay (LOS) and therefore mitigate crowding, improve patient satisfaction, and improve ED operational and financial performance. However, the peer‐reviewed evidence regarding the impact of PIT programs on measures including ED LOS, wait times, and costs (as variously defined) is mixed. Mechanistically, PIT programs exert their effects by initiating diagnostic work‐ups earlier and, sometimes, by equipping triage providers to directly disposition patients. However, depending on local contextual factors—including the co‐existence of other front‐end interventions and delays in ED throughput not addressed by PIT—we demonstrate how these features may or may not ultimately translate into reduced ED LOS in different settings. Consequently, site‐specific analysis of the root causes of excessive ED LOS, along with mechanistic assessment of potential countermeasures, is essential for appropriate deployment and successful design of PIT programs at individual EDs. Additional motivations for implementing PIT programs may include their potential to enhance patient safety, patient satisfaction, and team dynamics. In this conceptual article, we address a gap in the literature by demonstrating the mechanisms underlying PIT program results and providing a framework for ED decision‐makers to assess the local rationale for, operational feasibility of, and financial impact of PIT programs.
- Subjects :
- emergency department crowding
patient satisfaction
RC86-88.9
business.industry
Financial impact
emergency department physician in triage
patient flow
Psychological intervention
Medical emergencies. Critical care. Intensive care. First aid
Emergency department
The Practice of Emergency Medicine
medicine.disease
Triage
Crowding
Patient safety
Patient satisfaction
emergency department provider in triage
Software deployment
patient safety
Medicine
emergency department boarding
Medical emergency
hospital capacity
business
Concepts
Subjects
Details
- Language :
- English
- ISSN :
- 26881152
- Volume :
- 2
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Emergency Physicians Open
- Accession number :
- edsair.doi.dedup.....d3edaef277ef129027bf7df5753f3ff9