Advanced triage to redirect non-urgent emergency department visits to alternative care centers: the PERSEE algorithm

[en] Objectives: Primary care treatable visits in the Emergency Department (ED) are part of the different factors leading to the overcrowding. Their triage and diversion to alternative care centers could potentially help manage the increasing inflow provided the establishment of an advanced triage to ensure patients’ safety. We aim to suggest a new triage tool, PERSEE, and prove its feasibility, safety and performance. Methods: All self-referrals presented to the ED were triaged with the PERSEE algorithm: first, patients were classified with a five-level ED acuity scale and then evaluated by algorithms to determine their appropriate category (ED or Primary Care). Patients were eligible for a redirection if they were triaged by the acuity scale as level 3 or lower, considered as ambulatory patients and finally categorized as primary care patients. We defined appropriate redirections as patients requiring less than three emergency resources, no emergency-specific treatment and no hospitalization. Results: During the study, 1999 patients were admitted to the ED. Among those, 1333 patients were self-referred (66.9%) of whom 1167 patients were triaged as level 3 or below (58.6%) and 775 patients triaged as ambulatory (39.0%). Among the 775 patients, 200 patients were categorized as primary care treatable (10.0%) and thereby, as potentially eligible for a redirection. We noticed an error rate of 7%, sensitivity of 24.06% and specificity of 97.6%. The redirection rate reached 15% of the self-referrals. Conclusion: These results indicate that PERSEE triage could lead to a safe redirection and could be an efficient tool to reduce ED crowding provided several adjustments.

Disciplines :

Public health, health care sciences & services

Author, co-author :

GILBERT, Allison ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service des urgences

BRASSEUR, Edmond ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service des urgences

PETIT, Meredith ; Centre Hospitalier Universitaire de Liège - CHU > Département infirmier > Urgences Sart-Tilman

Donneau, Anne-Françoise ; Université de Liège - ULiège > Département des sciences de la santé publique > Biostatistique

D'Orio, Vincenzo ; Université de Liège - ULiège > Département des sciences cliniques > Médecine d'urgence - bioch. et phys. hum. normales et path.

GHUYSEN, Alexandre ; Centre Hospitalier Universitaire de Liège - CHU > Autres Services Médicaux > Service des urgences

Language :

English

Title :

Advanced triage to redirect non-urgent emergency department visits to alternative care centers: the PERSEE algorithm

Publication date :

15 April 2021

Journal title :

Acta Clinica Belgica

ISSN :

1784-3286

eISSN :

2295-3337

Publisher :

Taylor and Francis, Abingdon, United Kingdom

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 22 April 2021

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