Physician in Triage Versus Rotational Patient Assignment

Stephen Traub, Adam C. Bartley, Vernon D. Smith, Roshanak Didehban, Christopher A. Lipinski, Soroush Saghafian

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Physician in triage and rotational patient assignment are different front-end processes that are designed to improve patient flow, but there are little or no data comparing them. Objective: To compare physician in triage with rotational patient assignment with respect to multiple emergency department (ED) operational metrics. Methods: Design-Retrospective cohort review. Patients-Patients seen on 23 days on which we utilized a physician in triage with those patients seen on 23 matched days when we utilized rotational patient assignment. Results: There were 1,869 visits during physician in triage and 1,906 visits during rotational patient assignment. In a simple comparison, rotational patient assignment was associated with a lower median length of stay (LOS) than physician in triage (219 min vs. 233 min; difference of 14 min; 95% confidence interval [CI] 5-27 min). In a multivariate linear regression incorporating multiple confounders, there was a nonsignificant reduction in the geometric mean LOS in rotational patient assignment vs. physician in triage (204 min vs. 217 min; reduction of 6.25%; 95% CI -3.6% to 15.2%). There were no significant differences between groups for left before being seen, left subsequent to being seen, early (within 72 h) returns, early returns with admission, or complaint ratio. Conclusions: In a single-site study, there were no statistically significant differences in important ED operational metrics between a physician in triage model and a rotational patient assignment model after adjusting for confounders.

Original languageEnglish (US)
JournalJournal of Emergency Medicine
DOIs
StateAccepted/In press - Aug 31 2015

Fingerprint

Triage
Physicians
Hospital Emergency Service
Length of Stay
Confidence Intervals
Linear Models

Keywords

  • ED front-end
  • Physician in triage
  • Rotational patient assignment

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Traub, S., Bartley, A. C., Smith, V. D., Didehban, R., Lipinski, C. A., & Saghafian, S. (Accepted/In press). Physician in Triage Versus Rotational Patient Assignment. Journal of Emergency Medicine. https://doi.org/10.1016/j.jemermed.2015.11.036

Physician in Triage Versus Rotational Patient Assignment. / Traub, Stephen; Bartley, Adam C.; Smith, Vernon D.; Didehban, Roshanak; Lipinski, Christopher A.; Saghafian, Soroush.

In: Journal of Emergency Medicine, 31.08.2015.

Research output: Contribution to journalArticle

Traub, Stephen ; Bartley, Adam C. ; Smith, Vernon D. ; Didehban, Roshanak ; Lipinski, Christopher A. ; Saghafian, Soroush. / Physician in Triage Versus Rotational Patient Assignment. In: Journal of Emergency Medicine. 2015.
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