Implementation of the Canadian Emergency Department Triage and Acuity Scale (CTAS) in the Principality of Andorra: Can triage parameters serve as emergency department quality indicators?

Objective: To assess the performance of the newly implemented Canadian Emergency Department Triage and Acuity Scale (CTAS) triage system in a redesigned 200-bed community hospital emergency department (ED) and to evaluate the predictive validity of CTAS in this setting.

Methods: Triage system performance was analyzed on the basis of 4 quality indicators: time to triage; triage duration; proportion of patients who left without being seen by a physician; and waiting time to nurse and physician, stratified by triage level and reported as fractile response rates. The predictive validity of CTAS was evaluated by investigating the relationship between CTAS level, hospitalization index, ED length of stay (LOS) and diagnostic test utilization.

[Case mix analysis of patients who can be referred from emergency department triage to primary care].

Objective: Structured emergency department (ED) triage scales can be used to develop patient referral strategies from the ED to primary care. The objectives of the present study were to evaluate the percentage of patients who could potentially be referred from triage to primary care and to describe their clinical characteristics.

Methods: We analyzed all patients with low acuity (triage levels IV and V) and low complexity (patients discharged from the ED) triaged during 2003 with the Andorran Triage Model in the ED and estimated the percentage of patients who could potentially be referred on the basis of three primary care models: A, centers unable to deal with emergencies or perform complementary investigations; B, centers able to deal with emergencies and perform complementary investigations, and C, centers able to deal with emergencies but unable to perform complementary investigations.