Development of a Patient Triage and Service Prioritization System for Frontline Screening Points in Emergency and Forensic Medicine Department at Thawat Buri Hospital

Abstract

Purposes : To develop and evaluate the outcomes of a patient triage and prioritization system for the frontline screening point at the Emergency and Forensic Medicine Department of Thawat Buri Hospital.

Study design : A research and development study.

Materials and Methods : Key informants included 30 physicians and registered nurses working at the frontline screening point and 300 patients who received services at the same point. Participants were selected using simple random sampling, between February and September 2024. The evaluation of emergency patient triage quality was conducted using triage assessment forms, records of over/under-triage incidents, incident logs, and structured focus group questions. Data were analyzed using frequency, percentage, mean, and standard deviation.

Main findings : 1) Identified issues in emergency patient triage: Problems were attributed to service system inefficiencies, personnel, and equipment limitations. 2)Development of the triage and prioritization system: The system included the following steps: analyzing the situation and root causes of problems, developing and refining triage processes, adjusting service systems, improving communication and information transfer, and monitoring and continuous improvement, and 3) Outcome evaluation: The accuracy of patient triage was 95.00%, while incorrect triage occurred in 5.00% of cases. Under-triage incidents accounted for 1.00% (3 cases), and over-triage incidents accounted for 4.00% (12 cases). Among these, most discrepancies were related to ESI-3 being triaged as ESI-2 (5 cases; 1.25%) and ESI-4 being triaged as ESI-3 (5 cases; 1.25%).

Conclusion and recommendations : The triage system developed through this study significantly reduced triage discrepancies. Relevant organizations should consider adopting this system in community hospitals.