Decreasing Door-to-triage Times in the Emergency Department

Abstract

In the emergency department, patients who are waiting for triage present with potentially time-sensitive and life-threatening conditions. The period of time between arrival and triage is rarely discussed in the literature, and there are no established, evidence-based goals or standard recommendations. This project developed and implemented a novel algorithm designed to decrease door-to-triage (DTT) time to under 10 minutes by reallocating qualified nursing staff at peak triage times. The Plan Do Study Act quality improvement model was used throughout the project. Findings showed that staff responding to decompress triage based on algorithm triggers led to a decreasing trend in DTT times and a decrease in the rate of patients leaving without being seen by a provider over a 12-week implementation period. However, staff response was affected by barriers such as staffing, holding admission patients, not meeting algorithm conditions, and patient acuity. This project demonstrates the positive effects of decreasing and tracking time-to-triage in the emergency department setting on patients, staff, and healthcare systems. It also highlights barriers to timely triage and recommendations for further study.