RT Journal Article
SR Electronic
T1 Validation of the Taiwan triage and acuity scale: a new computerised five-level triage system
JF Emergency Medicine Journal
JO Emerg Med J
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 1026
OP 1031
DO 10.1136/emj.2010.094185
VO 28
IS 12
A1 Chip-Jin Ng
A1 Zui-Shen Yen
A1 Jeffrey Che-Hung Tsai
A1 Li Chin Chen
A1 Shou Ju Lin
A1 Yiing Yiing Sang
A1 Jih-Chang Chen
A1 TTAS national working group
YR 2011
UL http://emj.bmj.com/content/28/12/1026.abstract
AB Objective An ideal emergency department (ED) triage system accurately prioritises patients on the basis of the urgency of interventions required to avoid under- or over-triage. The objective of this study was to develop and validate a five-level Taiwan triage and acuity scale (TTAS) with an electronic decision support tool.Methods This prospective, multicentre, observational study included 10533 patients triaged at 11 academic medical centres, 18 regional and four district hospitals. Adult patients presenting to the ED were independently triaged by the duty triage nurse in the usual way and trained research nurses using TTAS with a computerised decision support system. Weighted κ statistics were used to assess the reproducibility. Hospitalisation, length of stay, and medical resource consumption were analysed by TTAS acuity levels.Results Most cases were stratified into levels 2 to 3 by the existing four-level triage system, whereas the TTAS stratified most patients to levels 3 (41.4%) and 4 (25.0%), and only a small number to level 1 (3.9%) (resuscitation; most urgent). Weighted κ for TTAS assignment was 0.87 (95% CI 0.85 to 0.89). The decrease in mean medical resource consumption and hospitalisation rate was statistically significant with each decrease in the TTAS triage acuity level. The length of stay also decreased significantly as the TTAS level acuity fell from levels 2 to 5.Conclusions The TTAS was found to be a reliable triage system that accurately prioritises the treatment needed to avoid overtriage, more efficiently deploying the appropriate resources to ED patients.