Article Text

other Versions

PDF
Effectiveness of a five-level Paediatric Triage System: an analysis of resource utilisation in the emergency department in Taiwan
  1. Yu-Che Chang1,2,
  2. Chip-Jin Ng1,
  3. Chang-Teng Wu3,
  4. Li-Chin Chen4,
  5. Jih-Chang Chen1,
  6. Kuang-Hung Hsu5
  1. 1Department of Emergency Medicine, Chang Gung Memorial Hospital Linkou and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
  2. 2Department of Medical Education, Chang Gung Memorial Hospital Linkou and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
  3. 3Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Memorial Hospital Linkou and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
  4. 4Department of Nursing, Chang Gung Memorial Hospital and Linkou and College of Medicine, Chang Gung University, Tao-Yuan, Taiwan
  5. 5Laboratory for Epidemiology, Department of Health Care Management, Chang Gung University, Tao-Yuan, Taiwan
  1. Correspondence to Dr. Chip-Jin Ng or Professor Kuang-Hung Hsu, Department of Health Care Management, Chang Gung University, No 259, Wen-Hwa 1st Rd., Kwei-Shan, Tao-Yuan 333; khsu{at}mail.cgu.edu.tw

Abstract

Objectives To examine the effectiveness of a five-level Paediatric Triage and Acuity System (Ped-TTAS) by comparing the reliability of patient prioritisation and resource utilisation with the four-level Paediatric Taiwan Triage System (Ped-TTS) among non-trauma paediatric patients in the emergency department (ED).

Methods The study design used was a retrospective longitudinal analysis based on medical chart review and a computer database. Except for a shorter list of complaints and some abnormal vital sign criteria modifications, the structure and triage process for applying Ped-TTAS was similar to that of the Paediatric Canadian Emergency Triage and Acuity Scale. Non-trauma paediatric patients presenting to the ED were triaged by well-trained triage nurses using the four-level Ped-TTS in 2008 and five-level Ped-TTAS in 2010. Hospitalisation rates and medical resource utilisation were analysed by acuity levels between the contrasting study groups.

Results There was a significant difference in patient prioritisation between the four-level Ped-TTS and five-level Ped-TTAS. Improved differentiation was observed with the five-level Ped-TTAS in predicting hospitalisation rates and medical costs.

Conclusions The five-level Ped-TTAS is better able to discriminate paediatric patients by triage acuity in the ED and is also more precise in predicting resource utilisation. The introduction of a more accurate acuity and triage system for use in paediatric emergency care should provide greater patient safety and more timely utilisation of appropriate ED resources.

  • triage
  • cost effectiveness
  • paediatrics, paediatric emergency medicine
  • emergency department
View Full Text

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.