Emergency pyramid is inverting already

BMJ 2003; 326 doi: https://doi.org/10.1136/bmj.326.7379.49 (Published 04 January 2003) Cite this as: BMJ 2003;326:49
  1. Matthew Cooke, national clinical lead, emergency care performance improvement (m.w.cooke@warwick.ac.uk),
  2. Karen Castille, director of emergency care
  1. NHS Modernisation Agency, London SW1A 2NS

    EDITOR—Turner and Collinson suggestion that it is time to invert the knowledge pyramid in accident and emergency medicine.1 Triage was shown to be effective many years ago, when 30% of patients needed no further care in an emergency department.2

    Since then it has been shown that creating a one stop system for patients with minor injuries is also effective in reducing waits.3 Further redesign of having senior staff as the first clinical contact rather than a triage and wait approach …

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