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{
    "pk": 8277,
    "title": "Waiting for Triage: Unmeasured Time in Patient Flow",
    "subtitle": null,
    "abstract": "Introduction: \nThe Centers for Medicare and Medicaid Services (CMS) requires reporting of multiple time-sensitive metrics. Most facilities use triage time as the time of arrival. Little is known about how long patients wait prior to triage. As reimbursement to the hospital may be tied to these metrics, it is essential to accurately record the time of arrival. Our objective was to quantify the time spent waiting to be triaged for patients arriving to the emergency department (ED).\nMethods: \nWe conducted this study in an urban, academic, tertiary care center with approximately 54,000 annual ED visits. All patients arriving to the ED from November 1, 2012, to October 1, 2013, were enrolled. If patients didn’t go directly to a bed or triage, an observer greeted patients as they entered the ED and recorded the time of arrival. The triage time was recorded as normal. We calculated the difference between the arrival time and triage time.\nResults: \nThere were 50,576 patient visits during the study period. Of these, 7,795 (15.4%) patients did not go directly to a bed or triage. For patients who waited for triage, median time from arrival to triage was 11 minutes (IQR 5-19, range 1-105). When stratified by the number of new patients who arrived in the ED in the previous hour, the percentage of greeted patients who waited more than 10 minutes for triage was: 0-5 new patients – 12.4%; 6-10 new patients – 48.8%; 11-15 new patients – 64.4%; 16+ new patients – 68%.\nConclusion: \nPatients often waited more than 10 minutes to be triaged. As the number of patients registered in the previous hour increased, the percentage of patients who waited more than 10 minutes for triage increased significantly. During times of peak volume, 8.5% of all patients arriving to the ED waited more than 10 minutes for triage. This wait is not accounted for in the normal reporting of ED throughput times and metrics. [West J Emerg Med. 2015;16(1):–0.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Emergency Department Operations"
        },
        {
            "word": "triage"
        },
        {
            "word": "Quality Metrics"
        },
        {
            "word": "Waiting time"
        }
    ],
    "section": "Emergency Department Operations",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/4gj1g690",
    "frozenauthors": [
        {
            "first_name": "Christopher",
            "middle_name": "",
            "last_name": "Houston",
            "name_suffix": "",
            "institution": "Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Leon",
            "middle_name": "D.",
            "last_name": "Sanchez",
            "name_suffix": "",
            "institution": "Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Christopher",
            "middle_name": "",
            "last_name": "Fischer",
            "name_suffix": "",
            "institution": "Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Kathryn",
            "middle_name": "",
            "last_name": "Volz",
            "name_suffix": "",
            "institution": "Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        },
        {
            "first_name": "Richard",
            "middle_name": "",
            "last_name": "Wolfe",
            "name_suffix": "",
            "institution": "Beth Israel Deaconess Medical Center, Department of Emergency Medicine, Boston, Massachusetts",
            "department": "None"
        }
    ],
    "date_submitted": "2014-06-06T19:10:14Z",
    "date_accepted": "2014-06-06T19:10:14Z",
    "date_published": "2014-12-08T19:45:58Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/8277/galley/4738/download/"
        }
    ]
}