A simplified trauma triage system safely reduces overtriage and improves provider satisfaction: a prospective study

American Journal of Surgery
Robert R ShawhanMatthew J Martin

Abstract

Standard triage systems result in high rates of overtriage to achieve acceptably low undertriage. We previously validated optimal triage variables and used these to implement a new simplified triage system (NEW) at our hospital. All trauma entries from May 2010 to Feb 2013 were prospectively reviewed. Calculation of the undertriage and overtriage rates was based on the need for any urgent or life-saving intervention. We identified 704 trauma patients. Level 1 activations were reduced from 32% (OLD) to 19% in the NEW system (P < .05). Overtriage was reduced from 79% (OLD) to 44% in the NEW system (P < .01). The undertriage rate was 1.6% in the NEW system, compared with 1.2% in the OLD system (P = nonsignificant). Of all patients, 14% (63) required a life-saving intervention. There were no deaths among undertriaged patients. The NEW simplified triage system significantly reduced the rate of overtriage, while safely maintaining a low undertriage rate.

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Citations

May 11, 2016·Injury·Arnaud FollinRomain Pirracchio
Feb 23, 2018·World Journal of Surgery·Christian WaydhasDan Bieler
Oct 11, 2019·Prehospital and Disaster Medicine·Hiroko MiyagiHoward A Werman
Apr 27, 2016·The Journal of Trauma and Acute Care Surgery·Joshua B BrownFrancis X Guyette
Apr 25, 2018·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Philipp BrakenThomas Gross
Jun 20, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Christian WaydhasUNKNOWN TraumaRegister DGU
Feb 25, 2019·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Zohre NajafiAmir Mirhaghi
May 12, 2021·Journal of Pediatric Surgery·Andrew B NordinKaren A Diefenbach

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