Refusing care to emergency department patients: Evaluation of published triage guidelines

Robert (Bob) Lowe, A. B. Bindman, S. K. Ulrich, G. Norman, T. A. Scaletta, D. Keane, D. Washington, K. Grumbach

Research output: Contribution to journalArticle

103 Citations (Scopus)

Abstract

Study objective: To determine whether a set of published triage guidelines identifies patients who can safely be refused emergency department care. Design: Historical cohort study. Setting: A public hospital ED. Type of participants: All patients triaged during a one-week period who were not in the most acute triage category. Measurements: Two ED nurses, blinded to the study hypothesis, reviewed each triage sheet to determine whether the case met the published guidelines for refusing care. In addition, each ED record was reviewed for appropriateness; a visit was considered appropriate only if predetermined, explicit criteria were met and an emergency physician agreed that a 24-hour delay in care might have worsened the patient's outcome. Main results: Of the 106 patients who would have been refused care according to the triage guidelines, 35 (33%) had appropriate visits. Four were hospitalized. Conclusion: When tested in our patient population, the triage guidelines were not sufficiently sensitive to identify patients who needed ED care. Broad application of these guidelines may jeopardize the health of some patients.

Original languageEnglish (US)
Pages (from-to)286-293
Number of pages8
JournalAnnals of Emergency Medicine
Volume23
Issue number2
StatePublished - 1994
Externally publishedYes

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Triage
Hospital Emergency Service
Guidelines
Public Hospitals
Emergency Medical Services
Emergencies
Cohort Studies
Nurses
Physicians
Health
Population

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Lowe, R. B., Bindman, A. B., Ulrich, S. K., Norman, G., Scaletta, T. A., Keane, D., ... Grumbach, K. (1994). Refusing care to emergency department patients: Evaluation of published triage guidelines. Annals of Emergency Medicine, 23(2), 286-293.

Refusing care to emergency department patients : Evaluation of published triage guidelines. / Lowe, Robert (Bob); Bindman, A. B.; Ulrich, S. K.; Norman, G.; Scaletta, T. A.; Keane, D.; Washington, D.; Grumbach, K.

In: Annals of Emergency Medicine, Vol. 23, No. 2, 1994, p. 286-293.

Research output: Contribution to journalArticle

Lowe, RB, Bindman, AB, Ulrich, SK, Norman, G, Scaletta, TA, Keane, D, Washington, D & Grumbach, K 1994, 'Refusing care to emergency department patients: Evaluation of published triage guidelines', Annals of Emergency Medicine, vol. 23, no. 2, pp. 286-293.
Lowe RB, Bindman AB, Ulrich SK, Norman G, Scaletta TA, Keane D et al. Refusing care to emergency department patients: Evaluation of published triage guidelines. Annals of Emergency Medicine. 1994;23(2):286-293.
Lowe, Robert (Bob) ; Bindman, A. B. ; Ulrich, S. K. ; Norman, G. ; Scaletta, T. A. ; Keane, D. ; Washington, D. ; Grumbach, K. / Refusing care to emergency department patients : Evaluation of published triage guidelines. In: Annals of Emergency Medicine. 1994 ; Vol. 23, No. 2. pp. 286-293.
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