4.0 Article

Factors influencing door-to-triage- and triage-to-patient administration-time

Journal

AUSTRALASIAN EMERGENCY CARE
Volume 25, Issue 3, Pages 219-223

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.auec.2022.01.001

Keywords

Emergency Department; Triage; Emergency medical service; Patient handoff; Crowding

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This study aimed to identify factors influencing door-to-triage and triage-to-patient administration times in an emergency department. The results showed that weekends, frequency of patients with urgent conditions, and ambulance activity significantly increased door-to-triage times.
Background: Overcrowding decreases quality of care. Triage and patient administration are possible bottlenecks. We aimed to identify factors influencing door-to-triage- and triage-to-patient administration-time in a prospective observational study at a tertiary care center with 70,000 patients per year.Methods: Measurement of aforementioned times at convenience-sampled time intervals on 16 days. Linear regression modelling with times as dependent variable, and demographic, medical and structural factors as covariables, testing for interactions with risk factor weekend.Results: We included 360 patients (183 female (51%)). Median door-to-triage-time was 6 (IQR 3-11) minutes, triage-to-patient administration-time was 5 (IQR 3-8) minutes. Overall door-to-triage-time was significantly shorter during weekends compared to weekdays (absolute difference 3 (IQR 1-7) minutes; 5 (IQR 3-8) vs. 8 (IQR 4-15) minutes, p < 0.01). Other influencing factors were closing hours of non-emergency department healthcare facilities (3.5 min more), number of ESI 2 patients seen during the interval (3 min more for each patient per hour), and ambulance activity (2 min more for each patient per hour brought by ambulance).Conclusions: Day of time and week as well as frequency of patients with urgent conditions and those brought by ambulance significantly increased door-to-triage times. This should be kept in mind when organizing ED workflow.(c) 2022 The Authors. Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia.

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