The Effect of Team Triage on ER Wait Times

Every year, millions of emergency room patients in the United States leave the hospital before ever being evaluated by a physician. Most cite long ER wait times as the cause of their departure, a factor that strongly correlates with increased patient morbidity and mortality. At a Metro Atlanta hospital, patients that are discharged spend almost three hours in the emergency room, and patients that are admitted stay in the department for over six hours. Long emergency waits are linked to many factors including high patient volume, delays in lab collections or radiological imaging, prolonged admissions processes, and disorganized triage systems. This Metro Atlanta hospital currently utilizes a triage model that relies on sequential processing, wherein patients must wait to be seen by a triage nurse, then wait for hospital registration, then wait for an available bed, and then wait again to be evaluated by a provider. This project aims to modify the hospital’s triage model to one of parallel processing in order to begin the patient assessment process simultaneously alongside triage, thereby decreasing total wait time. With parallel processing, initial triage will be performed at once by three entities: the triage nurse, patient registration, and a medical provider. This “team triage” allows patient care to begin before they are even assigned a bed on the floor. While the patient waits for a bed, doctors can begin prescribing medications and ordering labs or imaging for the patient to receive the moment they reach their room. Team triage will be implemented over a three-month trial run to see whether or not the average ER length of stay changes. Based on the experiences of other facilities that have implemented similar models, it is expected that total wait time in this department will decrease by a minimum of 45 minutes