The Particulars: Many EDs now include a physician at triage in an effort to improve flow and expedite care. Reports on the outcomes of making this change have been mixed, and its impact on common throughput metrics is not well known.

Data Breakdown: Investigators conducted a before-and-after study in which they moved the triage physician to the main ED and reassigned staff to create teams. These teams included one mid-level physician or physician assistant, an attending physician, at least one nurse, and a technician. Patients were triaged by a nurse, assigned to a team, and pulled into the main ED by that team rather than by the charge nurse.  When compared with the month preceding the intervention and the same 3 months of the previous year, the research found that the following all decreased during the 3 months following the change:

  • Time to provider.
  • Time to attending.
  • Time to disposition.
  • Length of stay.
  • The number of patients who left without being seen.

Take Home Pearl: Moving an attending physician from triage to a team in the main ED appears to improve patient throughput times and achieve other important benefits.