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

Am J Surg. 2015 May;209(5):856-62; discussion 862-3. doi: 10.1016/j.amjsurg.2015.01.008. Epub 2015 Feb 19.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: The NEW simplified triage system significantly reduced the rate of overtriage, while safely maintaining a low undertriage rate.

Keywords: Overtriage; Trauma system; Trauma triage; Undertriage.

MeSH terms

  • Adult
  • Algorithms*
  • Female
  • Humans
  • Male
  • Personal Satisfaction*
  • Prospective Studies
  • Trauma Centers / organization & administration*
  • Trauma Severity Indices
  • Triage / standards*
  • Wounds and Injuries / diagnosis*