Advanced triage protocols in the emergency department: A systematic review and meta-analysis.
Cecilia Biasibetti Soster, Fernando Anschau, Nicole Hertzog Rodrigues and 2 others
PMID 35293563WHAT IT FOUND
Advanced triage protocols reduced emergency department length of stay by 36 minutes, but the evidence was weak and protocols varied.
Exam requests did not differ, and satisfaction findings were mixed.
Key findings
01Advanced triage protocols reduced emergency department length of stay by 36 minutes.
02The number of exams requested did not differ between advanced triage protocols and usual triage.
03Patient and professional satisfaction findings were mixed, with some studies reporting increased satisfaction and one study finding no difference.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The main length-of-stay result had very low certainty and high heterogeneity (I²=90%), and the included trials used different advanced triage protocols, so the effect of any single component cannot be separated. Only 10 studies were available for qualitative analysis and 9 for meta-analysis, and publication bias was considered. Participants were not blinded, and in some studies evaluators were not blinded, which may affect reported outcomes. Length-of-stay means were converted from medians because most studies reported medians, which can introduce error. Satisfaction was not analysed consistently across studies; some studies reported increased satisfaction, while one found no difference.
The easy way to misread this
Do not conclude that advanced triage protocols reliably shorten emergency department stays by 36 minutes for all patients. The overall reduction had very low certainty, high heterogeneity, and the trials used different protocols, so the result may not apply to a given service.