Outcomes
Time-to-treatment
The time-to-treatment criteria attached to the ATS categories describe the ideal maximum time a patient can safely wait for medical assessment and treatment. The extent to which these criteria can be met is routinely evaluated against nationally recommended performance standards for each of the five ATS categories. These performance indicator thresholds are outlined in the Australasian College for Emergency Medicine’ s policy document for the ATS 1 and are detailed in Table 2.1.
Table 2.1: ATS categories for treatment acuity and performance thresholds 1 |
ATS category |
Treatment acuity( maximum waiting time) |
Performance indicator(%) |
1 |
Immediate |
100 |
2 10 minutes 80 3 30 minutes 75 4 60 minutes 70 5 120 minutes 70
11
The performance indicators describe the minimum percentage of presentations per ATS category that are expected to achieve the ideal time-to-treatment criteria. In situations where achievement of a performance indicator is at risk, organisational strategies should be implemented to satisfy demand and meet clinical needs. 1
Consistency of triage
The degree to which clinicians agree on the allocation of a triage code across populations is a marker of the reliability of the ATS.
For more than a decade, research has been conducted to assess the consistency of triage achieved using the ATS. 17, 19, 20, 33 While these studies have been helpful in understanding the ways in which groups of nurses use the ATS, they have also repeatedly highlighted the difficulties associated with measuring triage consistency in clinical practice.
For this reason, evaluation of consistency of triage is carried out at a macro, rather than a micro level *. For example, the distribution of presentations across the five categories of the ATS, commonly referred to as‘ footprints’, is helpful in assessing consistency. These can be compared between EDs with similar demographic profiles to detect systemic under- or over-triage.
* See http:// www. aihw. gov. au / hospitals
Department of Health and Ageing – Emergency Triage Education Kit