Can an Emergency Department Triage Protocol Initiative Reduce the Length of Stay in Low-Acuity Patients? [paper]




Daemen, Cynthia

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The purpose of this quality improvement project was to decrease emergency department (ED) length of stay (LOS) for low acuity patients. Overcrowded hospital Emergency Departments (ED) and long length of stays (LOS) can result in decreased quality of care and increased mortality. In addition, ED patients with long wait times and length of stays can negatively impact patient satisfaction scores, increase the likelihood for patient safety incidents, and increase overall cost of care. A patient’s LOS is the amount of time that is spent in total number of minutes from their arrival to their discharge from the ED. A patient’s wait time and LOS can be affected by several factors such as the number of patients in the department, ED admission holds, and staffing census. Triage is the area where most patients seeking ED care are screened and the nurse determines where the patient will be assigned. While often the ED cannot control holds or staffing, the triage time can be shortened using approved triage protocols to improve flow and decrease the number of patients in the department. This quality improvement project implemented an educational initiative to increase use of existing triage protocols and LOS for low acuity patients in a Level II trauma facility in Central Texas. The 12-month pre-intervention average LOS for patients seen in 2022 was 115 minutes and the average percentage of nurses using and documenting a triage protocol was 4.5%.



quality improvement, emergency department, triage, protocol, low-acuity, Nursing


Daemen, C. (2023). Can an emergency department triage protocol initiative Reduce the length of stay in low-acuity patients? St. David's School of Nursing, Texas State University.


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