A brief history of triage
The term‘ triage’ is derived from the French work trier, meaning to pick or to sort. 7 Triage systems were first used to prioritise medical care during the Napoleonic wars of the late 18th century. 8 Subsequent wars have led to the refinement of systems for the rapid removal of the injured from the battlefield to places providing definitive care. Mass Casualty Incident( MCI) triaging has also been developed and continues to evolve. The underlying principle of MCI triage is to achieve the greatest good for the greatest number of casualties in a setting where clinical demand overwhelms the available resources.
In civilian medicine, triage systems have been refined and adapted for use within a range of settings. In all health care environments, the triage process is underpinned by the premise that a reduction in the time taken to access definitive medical care will improve patient outcomes.
Emergency department triage
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Australia is experiencing increased public demand for emergency medical care. Current trends indicate a growth in the number of ED presentations in many locations; the reasons for this growth are varied and complex. 9
Standardised triage scales are useful in developing strategies to manage ED demand. In this context they can also be used to inform clinical service development, clinical risk management and patient safety. 10
Purpose of a triage system
The purpose of a triage system is to ensure that the level and quality of care that is delivered to the community is commensurate with objective clinical criteria, rather than administrative or organisational need. In this way, standardised triage systems aim to optimise the safety and the efficiency of hospital-based emergency services and to ensure equity of access to health services across the population.
The use of a standard triage system facilitates quality improvement in EDs, because it allows for comparisons of key performance indicators( i. e. time-to-treatment by triage category) both within and between EDs. Since the early 1990s the use of computerised information systems in Australian EDs has permitted the precise calculation of time-to-treatment against a variety of patient outcomes, including triage code, chief complaint, diagnosis and discharge destination.
Department of Health and Ageing – Emergency Triage Education Kit