Novel IT Application for Reverse Triage Selection: A Pilot Study

Abstract

The RTTL saves time in 2 ways. First, it reduces the patient population that needs to be evaluated for potential early discharge to one-third. Second, it doubles the probability of selecting an actual dischargeable patient. Each selected patient, however, still must undergo multidisciplinary reassessment in order to qualify for early discharge. Thus, further research is required to optimize the IT application.(Disaster Med Public Health Preparedness. 2018;12:599-605).

Primary Health Care and Disasters: Applying a “Whole-of-Health System” Approach through Reverse Triage in Mass-Casualty Management

“…Most of the articles described a simulated MCI scenario without specifying the type, except one describing a gas attack. [14][15][16][17][18][19][20][21][22] Satterthwaite (2012) was the only one describing the response to a real event. Seven out of ten studies involved one hospital.…”

“…Seven out of ten studies involved one hospital. 16,[18][19][20][21][22][23] Two studies involved, respectively, three and four hospitals within the same region. 14,15 One involved all acute hospitals in New York City (New York USA).…”

“…16,18,20 One study included only adults, 15 while another included both adult and pediatric in-patients. 22 Almost all studies aimed at investigating RT efficacy in creating hospital surge capacity by discharging patients to primary care early in an MCI response. [14][15][16][17][18][19][20][21]23 Among them, one investigated what resources were needed at the primary care level.…”

“…[14][15][16][17][18][19][20][21]23 Among them, one investigated what resources were needed at the primary care level. 19 Finally, the purpose of the study by Pollaris (2018) was to test a tool to guide clinical decision making in the RT process.…”

Can a reverse triage clinical decision support tool create sufficient surge capacity and reduce emergency department crowding?

“…This application, the Reverse Triage Tool Leuven, was able to detect hospitalized patients who undeniably could not be discharged early in case of a MCI. As such, the number of inpatients to be clinically evaluated for potential early discharge in MCIs was reduced by 65% [11].…”