Triage is a critical part of every hospital’s emergency department. As the gatekeeper, the efficiency and workflow of triage affect every other portion of the patient care journey. With such an important role, triage is constantly being evaluated and adjusted to optimize patient care, but some adjustments are more successful than others. And one is proving so successful that it may be here to stay.
Provider in Triage (PiT)
Many locations have a provider-in-triage system in place. In these programs, you typically have an NP/PA stationed in the triage area that works closely with the triage nurse. A patient comes in, tells their chief complaint to the nurse, and goes into the triage bay for vital signs, additional questions, and documentation.
Once the nurse is done with her part, the provider steps in to do a brief focused physical examination and patient history, collecting enough information to get initial orders in and the patient’s workup started.
PiT is a sound system. It decreases downtime for the patient and allows patients to get started on their care sooner, lowering overall time spent in the ED. Unfortunately, some hospitals aren’t large enough to justify having a provider in triage, and at times, the extra person can feel crowded and overwhelming. eTriage might be the solution to these issues.
The fundamental goal of eTriage is the same as provider-in-triage: allow a provider to see patients as soon as possible to get a jumpstart on their care. The main difference of the eTriage program is that the provider sees the patients virtually instead of in person.
In the eTriage system, the first steps are the same; however, the nurse and tele-provider see the patient together with the aid of a eTriage cart.
Reimagining PiT coverage models to a eTriage system has significant benefits.
Enhanced Patient Safety and Patient Experience
Provider-in-triage programs, including the eTriage model, better deploy front-end resources. They are able to address many patient concerns quickly, improving metrics with reduced door to provider times and LWOT rates.
When patients are seen more quickly, and there is a new avenue for reassessment opportunities, both patient safety and patient experience see significant improvements.
eTriage has the potential to double the amount of patients providers can see. Typically, triage providers see 4-5 patients per hour, but with the eTriage model, the workflow improves to allow for 8-10 patients per hour without negatively impacting quality.
Remote providers allow for more coverage flexibility than their in-person counterparts. Hospitals that see fewer patients in the ED can’t always afford to have a dedicated provider-in-triage. Tele-triaging allows for providers to cover more than one hospital at a time, making the program available to hospitals of all sizes.
The eTriage option also works well for flexing up during high volume times. EDs can immediately request another provider and get extra assistance without calling anyone in, keeping performance metrics stable across demand shifts and increasing patient satisfaction.
Set up for Success
As with any program, some factors make the shift to eTriage more successful.
Hospitals and health systems that have a fully integrated EMR system are the best candidates for eTriage. This system simplifies the triage process and allows the triage providers to access patient EMRs and streamline communication with the ED physicians.
Anytime you’re adding technology to patient encounters, a relationship with IT is imperative. Close collaboration and networking with the IT department helps pinpoint any potential technology issues and keeps everyone familiar with the hardware and software for more efficient troubleshooting.
A shift to eTriage touches several different groups, from the triage nurses and staff to the specialists on call. Keeping communication open and goals aligned helps create a team environment that allows everyone to be more successful.
Innovation in Care
The current health care environment is keeping everyone on their toes. The changes, surges, and shortages demand a constant reevaluation of existing systems and call for new and innovative models of care.
eTriage is one way hospitals and health systems can leverage technology and imagination to create a better patient experience and increase provider satisfaction.