ER triage pilot reduced wait times by more than 2 hours, study finds

Doctor and nurses wheeling patient in gurney through hospital corridor
Patients in the pilot program were admitted within 192 minutes after arrival to the ER compared to the other patients who were admitted 329 minutes after arrival. Getty/Sam Edwards

An experimental emergency room triage program that coordinated care with multiple departments at a Chicago hospital cut wait times of critically ill patients by more than two hours.

The study in the Annals of Emergency Medicine found that partnering and coordinating multiple service lines led to the reduction of patient admission decision times and got care more quickly to the hospital’s most ill patient population.

Researchers from the University of Chicago Medicine designed the pilot, known as “Dr. Admit,” to help clinicians identify early on the most ill patients in the emergency department and cut the time those patients had to wait by working closely with nurses, the lab, imaging and consulting resources to prioritize the patient’s care needs. Its goal was to help facilitate inpatient admission within an hour of activating the process.

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The research team collected data over a 12-month period on 11,820 patients admitted to the hospital that were triaged in the ER. Of those patients, 1,911 were admitted to the hospital as “Dr. Admit” patients. Researchers compared the two patient group’s actual time from arrival to the time of admission entered into the electronic medical record.

The difference in average admission time was significant. Patients in the pilot program were admitted within 192 minutes after arrival to the ER compared to the other patients who were admitted 329 minutes after arrival.

Study author Tom Spiegel, M.D., medical director at the hospital's emergency department, discussed the findings this week at the American College of Emergency Physician’s annual meeting. He explained that medical staff would answer a series of questions during the triage process, such as whether the patient looks sick and would likely be admitted, according to MedPage Today coverage of the conference. If the answers were yes, the pilot program was activated. If clinicians weren’t sure, they’d immediately refer the patient to an available physician for a potential admission into Dr. Admit.

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The pilot program not only reduced wait times for the most ill patients, Speigel said it fostered collaboration between ER physicians and nurses as well as other hospital departments. He recommended that other EDs adopt the program, MedPage Today reported, to improve patient care and encourage teamwork.