Healthcare, like most other industries, is in a constant state of improving operations through the use of new technology. This technology can span from medical computers and EHR records that compile patient notes to automated chatbots that speak to patients when doctors can’t and so much more.  And while this may be the case, the healthcare space deals with a very specific issue, one that is rather unique to that sector that other industries aren’t as impacted by: overcrowding. 

In cases of overcrowding in hospitals, some very difficult decisions need to be made in regards to patient priority and the division of resources used to treat said patients. Fortunately, when staff is stretched thin, when patients are flooding the ER, and when these incredibly challenging decisions need to be made, triage practices and technology come into play.

What is Triage?

Triage is the process of organizing and prioritizing patients based on who needs care most urgently. Categorizing any given patient within this hierarchy of care usually involves asking two key questions: 

    1. How urgently does this patient need care?
    2. What are this patient’s odds of survival if they receive that care?

This may sound rather morbid, but that adds up when you consider that triage processes were developed during World War I, when hospitals were at their most overcrowded with injured soldiers and citizens. It is a process that’s intended to be used when hospitals are at their most crowded and pressed for resources.

Today, triage is still used to prioritize space and equipment for those who can be saved if immediate care is administered. As such, it requires an impressive amount of foresight, attention to detail, and lightning quick, yet accurate, decision making. Naturally, frameworks already exist for making these game-time decisions.

The Triage Categories

A couple of systems exist for categorizing patients in scenarios where triage is necessary. 

START (Simple Triage and Rapid Treatment) is one such system that, like the name implies, is optimized for quick admittance and simplifies the triage process to an extent for those who haven’t received specialized triage training. START breaks patients into 4 general categories. 

    • Those who are beyond help and whose odds of survival will not change even if they receive care.
    • Those who can be helped but only through immediate intervention or transportation to a care facility. 
    • Those who are injured but who can afford to have their care delayed while more the severely injured are treated. 
    • Those with minor injuries who do not require urgent care. 

The START system is popular because it doesn’t require intensive training to perform. This is because these categories are rather general and patients can easily be categorized into them through minor questioning. The process doesn’t require a lot of processing, meaning it can be pretty readily employed by many staff members at a moment’s notice.

In more severe cases of mass injury, there’s also a more advanced method of triage that involves 5 categories, all identified by color-coded tags. 

    • Red Tag- Patients who cannot survive unless they receive immediate care.
    • Yellow Tag- Those who require care and observation but are currently stable and not in immediate danger. These patients might even be re-triaged every now and again to ensure their conditions haven’t worsened to the level of a red tag patient.
    • Green Tag- Those who are wounded and need care, but can afford to wait because their injuries aren’t life threatening. 
    • White Tag- Those with minor injuries that don’t require treatment. Those who can be dismissed. 
    • Black Tags- Those who are deceased or have extreme injuries that won’t survive with the care that’s available at the facility.

This system requires much more deliberation and more trained personnel in order to categorize patients. This is specifically due to the distinction between red and yellow tags that can be very minute. Choosing how to categorize these two cases takes a lot of attention to symptoms and injuries. Since mis-categorization between these two tags can lead to death, this method of triage takes careful training and specialized staff.

Methods of Triaging

Just like every other healthcare practice, the right technology can go a long way towards optimizing it or adapting it to meet current social need, today’s coronavirus-impacted economy being a perfect example of times where adapted healthcare is necessary. Here are only a few unique methods of triage that may or may not fit your facility’s needs. 

RFID-Based Triage

When dealing with injury/health assessment, timing is key, especially if you’re dealing with a red tag patient. Understanding this need for responsive triage, RFID badges and scanners have become a popular solution to quickly assessing a patient’s level of risk and moving them through care.

By giving a patient an RFID bracelet and scanning them into a system with an RFID equipped medical tablet, physicians can quickly input symptoms and risk levels, updating their colleagues in real time in regards to the state of their waiting room. 

In cases where immediate care is necessary, staff can be immediately notified and brought over to help admit a patient. The same can be said for cases where a patient’s risk level changes. For example, if a patient with a yellow tag level is put into the system, as soon as they pass the threshold into needing immediate care, everyone can be notified so they can jump into action at a moment’s notice. Tracking patients in this way also gives staff a readily updated reading on how much space and beds are available, which makes an impact on which patients are admitted and which are sent home to rest or self-quarantine.

Upon testing this method of triage, Homeland Security found that it lowered triage times from an average 5 minutes per patient to a mere 10-30 seconds per patient.

Teletriage

With telehealth technology sky-rocketing in popularity even before the current global pandemic, it was only natural that facilities turn to video-based triage when their physical space becomes too limited.

Jefferson Health recently undertook teletriage practices in full force when they noticed the COVID 19 outbreak pick up speed. By speaking with patients over video chats, they were able to quickly take down any symptoms the patient was feeling and give them an educated opinion on whether or not they should come in for a closer look. 

According to the team, they saw noticeable decreases in the amount of time spent during each triage, making it possible to speak to exponentially more patients. Instead of long appointments, visits lasted, at most,14 minutes. All that was needed was to hop on a call, describe symptoms, answer some questions, and then move on to another patient.

Self-Triage Using Chatbots

When hospitals are overcrowded and can’t afford to have anyone come in unless they’re at red or yellow-tag levels, giving patients the tools they need to self-triage becomes popular. 

Self-triage, or triage done by patients themselves using different tools and resources to educate their decisions, has jumped up in popularity, especially during the current COVID-19 outbreak that’s caused everyone to self-quarantine. And chatbots have become a resoundingly effective means of giving patients the ability to gauge the severity of their own symptoms with more accuracy. 

Several chatbot use cases have already been recorded, documenting instances where chatbots have been retooled and reconfigured with information regarding COVID19 symptoms. Being trained on this new information, chatbots such as Providence Health’s Grace are able to field questions from patients about symptoms and determine whether or not they should self quarantine or come in for immediate treatment.

Triage is About Preparing for the Storm

Odds are mass triage isn’t something your facility will use daily, it’s something that’s reserved for the crazier nights in an ER. That said, today’s developments have taught us that preparation for the days where triage is necessary can save time, resources and, most importantly, lives. For more information on triage and the tech needed to put it into practice, contact an expert from Cybernet today.

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