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Best Practices—The Door-to-Doc Interval
Published in Jody Crane, Chuck Noon, The Definitive Guide to Emergency Department Operational Improvement, 2019
Many EDs are placing stat lab systems in triage to further accelerate the throughput of lower-acuity patients. These include I-stat™, Biosite™ cardiac markers, urinalysis, influenza screening, and rapid strep. In effect, many EDs are transforming their front end into an urgent care center, which makes sense, given the current and potential future patients who will be visiting the ED. The evolution of telemedicine has brought potential enhancements to the triage process. Some EDs are beginning to experiment with employing a virtual physician that screens patients on arrival and gets work-ups started. While the efficacy and efficiency of these innovations are still to be determined, we encourage new thinking in the sincere interest of improving patient care. In any respect, developing an innovative approach to your front end will dramatically enhance your patient flow, improve quality by providing timely care, enhance patient and staff satisfaction, and improve revenue by accommodating greater throughput.
Triage with RFID Tags for Massive Incidents
Published in Syed Ahson, Mohammad Ilyas, RFID Handbook, 2017
Sozo Inoue, Akihito Sonoda, Hiroto Yasuura
A variety of information systems can be considered to be useful to support triage, such as wireless and mobile telemedicine systems [13]. Wireless network composition for such an application is discussed [14]. Tiny devices such as sensors to the network are tried to be used for vital sensors for injured people [12]. Active RFID tags are tried to be used for tracking the location of injured people [15].
Triage with RFID Tags for Massive Incidents
Published in Mohammad Ilyas, Sami S. Alwakeel, Mohammed M. Alwakeel, el-Hadi M. Aggoune, Sensor Networks for Sustainable Development, 2017
Sozo Inoue, Akihito Sonoda, Hiroto Yasuura
A variety of information systems can be considered to be useful to support triage, such as wireless and mobile telemedicine systems [13]. Wireless network composition for such an application is discussed [14]. Tiny devices such as sensors to the network are tried to be used for vital sensors for injured people [12]. Active RFID tags are tried to be used for tracking the location of injured people [15].
Routing and staffing in emergency departments: A multiclass queueing model with workload dependent service times
Published in IISE Transactions on Healthcare Systems Engineering, 2023
Siddhartha Nambiar, Maria E. Mayorga, Yunan Liu
Improving patient flow is challenging because the rate of patient arrivals to a hospital is uncertain both in timing and volume (Denton, 2013). Despite this uncertainty, EDs have it in their power to manage the flow of patients once they arrive in order to provide effective care. Emergency departments typically stratify incoming patients into groups based on their severity. Examples of triage systems being used by hospital systems today to assess the severity of incoming patients’ conditions include the Australasian Triage Scale (ATS) (Considine et al., 2004), the Canadian Triage and Acuity Scale (CTAS) (Murray, 2003), the Manchester Triage System (MTS) (Parenti et al., 2014), and the Emergency Severity Index (ESI) (Tanabe et al., 2004). Hospitals use such groupings of patients to route them to appropriate units (or wards) within the ED for treatment. This routing (also known as “streaming”) of patients plays a vital role in improving the efficiency of an ED’s operations.
Emergency medical service resource allocation in a mass casualty incident by integrating patient prioritization and hospital selection problems
Published in IISE Transactions, 2020
The process of grouping patients and prioritizing them for EMS provision is called triage. In a triage process, patients are classified into several groups based on the severity of their injuries, based on which they are accordingly prioritized for transportation to a hospital. The most widely practiced triage system is “Simple Triage And Rapid Treatment (START)”, where patients are grouped into four classes – expectant, immediate, delayed, and minor (Jenkins et al., 2008). This classification is based on airway patency, breathing rate, the presence of radial pulse, and the ability to walk and follow commands. Once classified, START uses them to assign transport priority to the patients: the highest priority to patients is in the immediate class, the second–highest priority is in the delayed class, and the lowest priority is the remainder. Other triage methods (e.g., SALT (Sort–Assess–Life-saving intervention–Transport)), operate in a similar manner.
A resource-constrained, multi-unit hospital model for operational strategies evaluation under routine and surge demand scenarios
Published in IISE Transactions on Healthcare Systems Engineering, 2019
Mersedeh TariVerdi, Elise Miller-Hooks, Thomas Kirsch, Scott Levin
Patients arrive at the hospital with varying injury levels and service requirements. Triage protocols are used to classify and prioritize patients based on injury type, severity, and prognosis. A commonly used protocol for U.S. hospitals is described next and was replicated in the developed model. The prioritization of customers within each class is time-dependent, changing for individual patients in response to waiting times and initially estimated survival likelihoods. Upon arrival, patients are assigned to care paths based on their category and priority score. Customers from lower injury classes are assumed to be impatient and may choose to renege if waiting times are longer than acceptable. Hsia et al. (2011) showed that the number of LWBS cases can be as high as 20.3%. In the ED, approximately 4.4% of low severity patients leave the queue after waiting 90 minutes or longer (Khare et al., 2009). Additionally, patients may be transferred to other hospitals at a variety of points along their care paths.