Hoi Ying Emily Chan, Jonathan S C Cheng, Adam Bharmal, Velota Ct Sung
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引用次数: 0
Abstract
Purpose: The effect of pre-triage visual acuity (VA) measurement on triage accuracy in a busy ophthalmic casualty department was investigated as a possible means to improve triage quality.
Methods: All 576 patients attending the accident and emergency department (A&E) at the Birmingham and Midland Eye Centre (BMEC) over a period of 4 days were included in this prospective cross-sectional study. Patients were assigned to two groups: those who underwent a VA measurement prior to triage (n = 242) and a control group who did not have a VA measurement (n = 234). Clinicians who were masked from the allocation also assessed whether they agreed with the triage decision after assessing each patient.
Results: Triage outcomes were recorded for 469 (81%) patients. Those with a pre-triage VA measurement were more likely to be assessed as more urgent (p = 0.005) and less likely to be discharged (p = 0.04). 248 (43%) patients had clinician response with corresponding triage records, of which 136 (55%) had prior VA measurement and 112 (45%) were in the control group. Clinicians responded that patients with VA measurement prior to triage were more accurately triaged than the control group (66% and 54%; p = 0.03).
Conclusion: VA measurement prior to triage can help improve triage accuracy and allow better allocation of resources at an overcrowded eye-dedicated emergency department. However, waiting times may increase due to longer triage duration and more patients to be triaged into urgent pathway. Greater staffing resources may be necessary to complement the proposed change to avoid undermining triage efficiency.
期刊介绍:
Graefe''s Archive for Clinical and Experimental Ophthalmology is a distinguished international journal that presents original clinical reports and clini-cally relevant experimental studies. Founded in 1854 by Albrecht von Graefe to serve as a source of useful clinical information and a stimulus for discussion, the journal has published articles by leading ophthalmologists and vision research scientists for more than a century. With peer review by an international Editorial Board and prompt English-language publication, Graefe''s Archive provides rapid dissemination of clinical and clinically related experimental information.