Triage and patient safety in emergency departments

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d6652 (Published 20 October 2011) Cite this as: BMJ 2011;343:d6652
  1. Sven Oredsson, medical director
  1. 1Skane Regional Council, Dockplatsen 26, 205 25 Malmö, Sweden
  1. sven.oredsson{at}skane.se

Overcrowding calls for re-engineering of triage models and new patient flow processes

The emergency department is the point of entry for more than half of all patients admitted to hospital care, primarily because of an increasingly elderly population. Recent reports also show that more teenagers and young adults are seeking medical care in the emergency department.1 This phenomenon is characterised by expectations of medical service on a 24/7 basis. Together, these changes contribute to overcrowded emergency departments that put patient safety at risk.2

Can these changes be reversed or prevented? Most countries have put much effort into educating patients to use primary care facilities in semi-emergency situations. In general these efforts have failed, especially in urban areas, leaving only one choice—to accept the fact that visits to the emergency department will continue to increase.3 Changes in the organisation of the emergency department are therefore needed to prevent an increase in care related injuries.

Triage was adopted in the 1980s to prevent seriously ill patients from dying while waiting their turn. However, evidence shows that traditional triage increases waiting times rather …

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