Development of the Patient Triage According to the Level of Urgency at the Emergency and Forensic Department, Phanomphrai Hospital

Abstract

Purposes: To study the current situation, develop, and evaluate the effectiveness of a triage model based on the MOPH ED Triage system at the Emergency and Forensic Department, Phanom Phrai Hospital.

Study design: This study employed Action Research design, utilizing Soukup’s Evidence-Based Practice model as the conceptual framework, which consists of four phases: problem analysis, evidence retrieval, model development/pilot testing, and implementation/evaluation.

Materials and Methods: The participants included 18 healthcare providers, comprising 15 registered nurses, 3 Advanced Emergency Medical Technicians (AEMT). The research instruments included the developed 5-level MOPH ED Triage model, a clinical skill assessment form, and satisfaction surveys for both providers and patients. Data were collected between 2023 and 2025. Data analysis was performed using descriptive statistics, including percentages and means.

Main findings: 1) The situational analysis revealed significant triage errors, including under-triage (3.97 - 5.77%) and over-triage (4.64 - 6.89%), particularly during evening and night shifts among staff with less than five years of experience. 2) A standardized triage model was developed, incorporating clear criteria for the 5-level urgency system and mandatory re-triage protocols. And 3) Following the implementation, healthcare providers demonstrated higher competency and clinical skills. The accuracy of patient classification improved, leading to enhanced patient safety, reduced complications during waiting periods, and high levels of satisfaction among service users.

Conclusion and Recommendations: The implementation of a standardized triage model effectively enhances patient safety and reduces nursing errors in emergency settings. It is recommended that continuous triage competency training be provided, especially for less experienced staff, to maintain long-term performance standards.