If you work in a hospital setting or have ever had to go to the emergency room, chances are you have encountered some sort of triaging protocol. The word “triage” is derived from the French word “trier,” which means to sort, separate out, or select. Originally, it was defined as the sorting of patients in mass casualty situations. Now, it is defined in emergency medicine as an assessment when a patient arrives to an ER. In hospitals all over the world, triage has become a successful and imperative process for bringing effective care to millions of patients each day. Especially in an emergency, triage refers to the sorting of injured or sick individuals according to their specific need for certain medical attention.
Often, hospitals are understaffed and overpopulated, making it essential for an efficient triage system to be in place. This may include a color-coded triage coding system that helps emergency staff treat the most critical patients first. In a study that was published in the February 2020 Journal of Hospital Medicine, it showed that each hospital structures triagist roles differently. In some medical organizations, triagists are making hefty admissions decisions and seeing patients simultaneously in the emergency department who are being considered for admission. In other hospital settings, triagists are not the primary hospitalists making admissions decisions, but rather serving in more of a supervisory role to residents and advanced practice professionals. The conclusion? The role of the triagist can vary from organization to organization.
Regardless of how it is structured, the Journal of General Internal Medicine (JGIM) believes that all triagists should have specific curricular competencies that will assist them in making critical transitionary care. Among these are:
“Interpersonal communication and professionalism, systems-based thinking and understanding the health care system as it relates to the triagist role, and patient-centered care as it relates to the transition from the outpatient to inpatient setting.” (1)
As we all know, the emergency room is not like a buffet – it’s not first-come-first-served. An initial assessment of the patient will ensure that seriously ill individuals receive medical attention prior to those with more non-urgent issues. By using best clinical judgement, as well as validated and reliable five-level emergency department triage scales such as the Emergency Severity Index or the Canadian Triage and Acuity Scale, practitioners can decide on next steps. From there, it is decided on how the patient will be cared for, or if they will need to receive additional treatment elsewhere.
According to the American College of Emergency Physicians,
“The key to efficiency and clinical effectiveness in emergency care is based on reliable triaging. This will be predictive of outcomes reflective of illness severity such as mortality rate and resource requirements. Triage assignment would be done at a consistent point in the patient’s hospital visit (point of first contact in an episode of care), would be prospective, and would be done by experienced health care professionals with extensive experience in clinical judgement and decision-making. The triage process and rules must be easily understood, rapidly applied, have high rates of inter-rater agreement, facilitate appropriate placement, predict emergency department resource use requirements, and predict clinical outcome. Additionally, the adoption of a standardized triage scale could provide the basic yardstick for categorizing service intensity across jurisdictions.” (2)
In summary, it’s important to remember that triage care shouldn’t be practiced lackadaisically. By adhering to a specific set of practices and procedures, you are more likely to stay on the best course for not only your patients, but also your fellow employees.
The Bottom Line
The primary purpose of the triagist role is to determine how quickly someone needs to be seen and to save as many lives as possible. Setting priorities and utilizing proper resources can help lead to successful and accountable care. We understand that working as a triagist is not always easy and can be stressful and overwhelming at times. However, the reward of making a difference in the lives of others far outweighs any potential frustrations.
Learn More About Advanced Care Hospitalists (ACH)
ACH is a Lakeland-based hospitalist group providing comprehensive patient care in community hospitals across Central Florida. Our providers are highly skilled, board-certified internal medicine specialists who are available around-the-clock to meet the care needs of patients from hospital admission through discharge. Post-discharge from the hospital, we continue overseeing patient care for 30 days.
We’ve found that continued care coordination ensures more accurate medication reconciliation, improved compliance with discharge plans, better scheduling of follow-up visits, and fewer hospital readmissions. Our providers do everything in their power to make sure our patients receive the compassionate and comprehensive care they need to promote healing and prevent a second hospital admission.
For more information about our services and our practice, please contact Advanced Care Hospitalists at 863-816-5884 or fill out a contact form online.
- Wang, E.S., Velásquez, S.T., Smith, C.J. et al. Triaging Inpatient Admissions: an Opportunity for Resident Education. J GEN INTERN MED 34, 754–757 (2019). https://doi.org/10.1007/s11606-019-04882-2
- Fernandes, Christopher B., Groth, Stephen J., Johnson, Loren A., Rosenau, Alexander M., Sumner, J. Andrew, Begley, Doreen, Beveridge, Robert C., Eitel, David R., & Wuerz, Richard C. A Uniform Triage Scale in Emergency Medicine, Information Paper. Subcommittee on National Triage Scale, Emergency Medicine Practice Committee, 1-7 (1999). https://www.acep.org/globalassets/uploads/uploaded-files/acep/clinical-and-practice-management/resources/administration/triagescaleip.pdf