School of Public Health, Queensland University of Technology, Brisbane, Queensland, Australia.
Emerg Med J. 2010 Feb;27(2):86-92. doi: 10.1136/emj.2009.077081.
Triage is a process that is critical to the effective management of modern emergency departments. Triage systems aim, not only to ensure clinical justice for the patient, but also to provide an effective tool for departmental organisation, monitoring and evaluation. Over the last 20 years, triage systems have been standardised in a number of countries and efforts made to ensure consistency of application. However, the ongoing crowding of emergency departments resulting from access block and increased demand has led to calls for a review of systems of triage. In addition, international variance in triage systems limits the capacity for benchmarking. The aim of this paper is to provide a critical review of the literature pertaining to emergency department triage in order to inform the direction for future research. While education, guidelines and algorithms have been shown to reduce triage variation, there remains significant inconsistency in triage assessment arising from the diversity of factors determining the urgency of any individual patient. It is timely to accept this diversity, what is agreed, and what may be agreeable. It is time to develop and test an International Triage Scale (ITS) which is supported by an international collaborative approach towards a triage research agenda. This agenda would seek to further develop application and moderating tools and to utilise the scales for international benchmarking and research programmes.
分诊是现代急诊科有效管理的关键流程。分诊系统不仅旨在确保患者的临床公正，而且还为部门组织、监测和评估提供有效的工具。在过去的 20 年中，许多国家已经对分诊系统进行了标准化，并努力确保应用的一致性。然而，由于准入障碍和需求增加，急诊科的拥堵情况持续存在，这导致人们呼吁对分诊系统进行审查。此外，国际间分诊系统的差异限制了基准比较的能力。本文的目的是对与急诊科分诊相关的文献进行批判性回顾，以便为未来的研究提供方向。尽管教育、指南和算法已被证明可以减少分诊的差异，但由于决定任何患者紧急程度的因素的多样性，分诊评估仍然存在很大的不一致性。现在是时候接受这种多样性，接受已达成共识的内容，并接受可能达成共识的内容。现在是时候开发和测试一个国际分诊量表（ITS）了，该量表需要通过国际合作的方式来制定分诊研究议程。该议程将寻求进一步开发应用和调节工具，并利用这些量表进行国际基准测试和研究计划。
