Triage
Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar in Handbook of Refugee Health, 2021
Triage is the rapid sorting of a patients, with the aim of achieving the highest possible benefit for as many people as possible by prioritising the limited resources available. 1 Triage inevitably involves rationing care by prioritising those patients with the greatest need and those who will benefit the most from treatment. For this reason, triaging patients particularly in mass casualty incidents (discussed later) can be emotionally distressing for clinical staff; requires expertise, practice and planning; and inherently introduces ethical tensions.
What kind of patient self-referral service is right for you?
Lesley Holdsworth, Valerie Webster in Patient Self Referral, 2018
After gathering information about the population a therapist serves and the service that is currently delivered, it is time to consider exactly which kind of patient self-referral service is right for the therapist's overall needs. Not only are there different ways in which patients can access a therapist's service, either directly or indirectly themselves or by being referred by another healthcare practitioner, there are also different ways of providing patient self-referral services. This chapter provides a description of a range of options that are potentially available to a therapist. The systems are classified under the following headings: (1) Telephone systems, for advice, assessment and management decisions (triage), call back, self-referral, and appointment allocation; and (2) Face-to-face services, for drop-in clinics and managed waiting list approach. Before implementing any service the therapist must identify which system or blend of systems he/she intends to develop.
Introducing Models of Care
Richard Bryant-Jefferies, Don Lavoie in Models of Care for Drug Service Provision, 2018
The Models of Care document overall sets out a national framework for the commissioning of adult treatment for drug misuse expected to be available in every part of England to meet the needs of diverse local populations. An integrated care pathway (ICP) is essentially a description of the nature and anticipated course of treatment for a particular client and a predetermined plan of treatment. In drug and alcohol treatment services, Quality in Alcohol and Drug Services (QuADS) standards on organisational management include specific standards on monitoring service activity and client outcome. Existing commissioning standards for those responsible for drug and alcohol treatment includes explicit standards on contract monitoring and information gathering vis-a-vis local population needs. Triage assessment is likely to be a client's first face-to-face contact with a drug treatment agency and this level of assessment should be available within all drug and alcohol services and community care assessment teams.
Development of a biodosimeter for radiation triage using novel blood protein biomarker panels in humans and non-human primates
Published in International Journal of Radiation Biology, 2020
Robert P. Balog, Rowena Bacher, Polly Chang, Michael Greenstein, Songeeta Jammalamadaka, Harold Javitz, Susan J. Knox, Shirley Lee, Hua Lin, Thomas Shaler, Lei Shura, Paul Stein, Kathryn Todd, David E. Cooper
Purpose: In a significant nuclear event, hundreds of thousands of individuals will require rapid triage for absorbed radiation to ensure effective medical treatment and efficient use of medical resources. We are developing a rapid screening method to assess whether an individual received an absorbed dose of ≥2 Gy based on the analysis of a specific panel of blood proteins in a fingerstick blood sample. Materials and methods: We studied a data set of 1051 human blood samples obtained from radiotherapy patients, normal healthy individuals, and several special population groups. We compared the findings in humans with those from irradiation studies in non-human primates (NHPs). Results: We identified a panel of three protein biomarkers, salivary alpha amylase (AMY1), Flt3 ligand (FLT3L), and monocyte chemotactic protein 1 (MCP1), which are upregulated in human patients receiving fractionated doses of total body irradiation (TBI) therapy as a treatment for cancer. These proteins exhibited a similar radiation response in NHPs after single acute or fractionated doses of ionizing radiation. Conclusion: Our work provides confidence in this biomarker panel for biodosimetry triage using fingerstick blood samples and in the use of NHPs as a model for irradiated humans.
Triage in psychiatric emergency services in Copenhagen: results from a descriptive 1-year evaluation study
Published in Nordic Journal of Psychiatry, 2017
Ditte Sæbye, Erica Bernt Høegh, Joachim Knop
Inspired by the Australasian triage system, a regional psychiatric triage system was introduced in the psychiatric emergency units (PEUs) in Copenhagen in 2011. Our aim of the study is to determine the characteristics of the patient according to the defined triage criteria and check if this is in accordance with recommendations. A random 10% data sample was obtained throughout 2012 in three PEUs of Copenhagen. Triage category, demographic, social and clinically relevant variables were collected. A total of 929 contacts were registered. We found significant associations between triage category and several clinical parameters. Time of visit was correlated to diagnoses. The results indicate that use of the new triage system in emergency psychiatry has facilitated urgency categorization, reduced waiting time, and optimized clinical decisions. These goals are important clinical implications of the service in PEUs. The need for PEUs out-of-daytime (when all Community Mental Health Centers are closed) has also been demonstrated.
Therapeutic Assessment in Psychological Triage Using the PAI
Published in Journal of Personality Assessment, 2016
Joshua D. Brown, Leslie C. Morey
This case illustrates the utility of incorporating therapeutic assessment in a triage context that typically involves a focus on gathering information. A man referred to our clinic by a local mental health center was seen by our assessment team for a triage that includes the administration of a single psychological test, the Personality Assessment Inventory (PAI). Although this triage must rapidly gather information to determine client suitability and treatment assignment, we still attempt to work with clients to collaboratively develop goals for this assessment that include addressing questions that are central concerns for the clients. In this case, the test results suggested a severe disorder that accounted for many phenomena that he had been experiencing but had apparently been reluctant to share. The information gathered led to a referral to a different treatment program that could provide pharmacological and more intensive forms of treatment. However, the collaborative bond formed between the assessor and the client during this triage was sufficiently strong that it was our assessor to whom the client turned in a subsequent crisis precipitated by a symptomatic exacerbation. This case illustrates complementary information gathering and therapeutic goals of assessment even in the context of a brief assessment.
Related Knowledge Centers
- Mass Casualty Incident
- Physiology
- Emergency Medical Services
- Emergency Room
- Physician
- Triage Tag
- Continuous Integrated Triage