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Triage in accident and emergency departments

BMJ 1995; 311 doi: (Published 12 August 1995) Cite this as: BMJ 1995;311:404
  1. Andrew B Bindman, Dr Bindman is a Robert Wood Johnson Foundation generalist physician faculty scholar.
  1. Director Primary Care Research Center, Department of Medicine Box 1364, University of California, San Francisco, San Francisco, CA 94143-1364, USA

    We need to consider what kind of errors we can afford

    Triage practices in accident and emergency departments evolved from the military procedure of giving priority for medical care to those who were expected to benefit the most. The focus of triage in many accident and emergency departments today, however, is less on discriminating among the sickest patients and more on identifying patients who may not need emergency care at all. The high cost of care in an accident and emergency department and long waiting times, which result in substantial numbers of patients leaving without being seen, have led to increased scrutiny of this clinical department.1 In the United States the growth in the use of accident and emergency departments has been attributed largely to the increase in the number of people without a regular source of primary care.2 In the United Kingdom the problem is not so much a lack of primary care providers but that these providers may not be technologically or organisationally equipped to evaluate and manage a number of acute problems.3 Investigators and policymakers in both countries …

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