The impact of enhanced triage on the emergency service with special track streams

Background: Over sixty percent of emergency department (ED) attendances belonged to the semi-urgent or non-urgent categories. The existing triage system failed to detect those patients in need of emergency service within these groups. It increased the risk to patients and affected the quality of care especially with overcrowding and long waiting time. Objective: To assess the impact of a special track program in providing medical services to targeted groups and on the overall emergency service. Method: Four special groups of patients triaged as semi- or non-urgent and required procedural interventions or possible in-hospital treatment were identified. The impact on waiting time, length of stay, rate of left without being seen and re-attendances rate were measured and studied prospectively. Results: A total of 438 cases were analysed. Special track groups had a shorter mean waiting time and mean disposal time (36.6 minutes and one hour) when compared with all category 4 patients. Special track group had no disappeared case and a smaller re-attendance rate. Conclusions: Special track program improves the safety and quality of care in patients of fast track streams without compromising care to other semi-urgent or non-urgent categories patients. (Hong Kong j.emerg. med. 2012;19:369-374)