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 Ciara



I personally have seen a medical practitioner at triage work very well.
They are able to provide:

*       Early prescription analgesia
*       Commence pathology and organ imaging investigations at the time
of presentation.

Thereby improving patient satisfaction and reducing total ED time of the
patient.

This system may be extended from the low-acuity patients in the waiting
room to the more ill patients who arrive by ambulance and are placed
directly in a cubicle. Thereby starting investigation and treatment
before a complete medical examination is undertaken.

Generally, when it works well patient and staff satisfaction is high.

Other areas to consider are:

*       What drives your reasoning for starting medicine at triage?
Delivery of early effective care, or a method of getting medicine to
sign on for the patient early and therefore "stop the clock" (this KPI
namely, time to be seen by a medicine practitioner in some public health
care systems being a determinant of funding)?
*       Is this the best method of deploying an expensive, highly
trained resource (an Emergency Physician). Or, have you employed more
Emergency Physicians? If so, is this the best use of the health
dollar/punt?
*       Is the goal to optimise care or really minimise the patient
complaint rate from those who are less ill and usually have to wait for
assessment?
*       Emergency Physicians are trained to examine the patient as a
whole and manage the patient throughout the illness experience. The move
to rapid assessment and intervention is a paradigm shift and may cause
considerable discomfort for those starting the process. The need to move
on (typically in 1-5 minutes) to the next patient is a skill that needs
to be acquired just as it is by the new Triage Nurse.





Chris Hawkins

Clinical Nurse Educator

Melbourne

Australia

For more information, send mail to [log in to unmask] with the message: info PED-EM-L
The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html