Cain P, Waldrop R D, Jones J
Department of Emergency Medicine, Louisiana State University Medical Center, Baton Rouge, LA, USA.
Acad Emerg Med. 1996 Jan;3(1):65-71. doi: 10.1111/j.1553-2712.1996.tb03306.x.
To evaluate the effect of altering pediatric triage criteria on ED triage scoring and patient flow.
A prospective observational study of a pediatric triage modification was performed. Data for all pediatric patients presenting to an urban general ED during a six-month study period were collected. After the first three months, pediatric triage criteria were altered by elevating the acuity of several historical items and specifically listing abnormal signs and symptoms. Outcome measures included triage score assignment, criteria making the patient emergent, proportion of emergent or urgent triage assignments, and times to examination, disposition, and admission.
Altering pediatric triage criteria resulted in a significant (p < 0.05) increase in the number of patients triaged as emergent (2% vs 15%) or urgent (48% vs 55%). In addition, for emergent and urgent patients there was a significant decrease (p < 0.05) in the mean times to ED examination (50 vs 44 min), floor admission (355 vs 245 min), and intensive care unit admission (221 vs 132 min). The triage changes that had a significant impact on these results were a history of color change, decreased activity, and prematurity with complications.
A significant improvement in pediatric patient flow occurred after posting age-specific abnormal signs and symptoms as well as elevating triage acuity for specific historical clues.
评估改变儿科分诊标准对急诊分诊评分和患者流程的影响。
对儿科分诊修改进行前瞻性观察研究。收集了在为期六个月的研究期间到城市综合急诊科就诊的所有儿科患者的数据。在最初三个月后，通过提高几个既往项目的 acuity 并具体列出异常体征和症状来改变儿科分诊标准。结果指标包括分诊评分分配、使患者为紧急情况的标准、紧急或紧急分诊分配的比例以及检查、处置和入院时间。
改变儿科分诊标准导致分诊为紧急情况（2%对15%）或紧急情况（48%对55%）的患者数量显著增加（p < 0.05）。此外，对于紧急和紧急患者，到急诊科检查的平均时间（50对44分钟）、病房入院时间（355对245分钟）和重症监护病房入院时间（221对132分钟）显著减少（p < 0.05）。对这些结果有显著影响的分诊变化是颜色变化史、活动减少和有并发症的早产。
在公布特定年龄的异常体征和症状以及提高特定既往线索的分诊 acuity 后，儿科患者流程有显著改善。
