January 19, 2021

Victorian-first ED pivot triage system

The Northern Hospital Emergency Department (ED) has become the first ED in Victoria to move to a new ‘pivot triage’ and self-registration system. The new triage system, which commenced yesterday on 18 January 2021, is designed to improve patient experience and door-to-physician time, and has already proven successful in the United States.

The idea originated after an internal process review, where the traditional triage and registration system were identified as bottle necks impacting patient flow and experience.

“Previously, patients would be seen by a triage nurse, then go back in the waiting room and wait for clerical staff to call them, get their details and put them in the system. Now, they can see the pivot nurse who uses critical care thinking skills to make a rapid assessment of the patient’s condition and determine urgency based on symptoms. The patient can then register electronically on their own via a QR code, with that information going directly to our clerical staff,” explained Janice Fernandes, ED Nurse Unit Manager.

Dr Loren Sher, Emergency Physician, added, “The pivot nurse model gets the patients in much quicker, as proven in the USA, and we are the first in Victoria to implement this model. Patients that are in category 4 and 5, as well as walk-in patients in category 3, will now be able to scan the QR code and put in their details electronically.”

“From our Virtual ED triage system, we learned that there are lot of time efficiencies when using an online system, and more accurate information is gathered if patients self-register. We are aiming to be quicker, faster, more efficient and more accurate in the process,” she said.

Trisha Abbey, Clerical Supervisor, ED, said the team found that sometimes patients don’t inform staff that they have changed their address or phone number. With the new process, patients are providing the most recent information, thus improving hospital data quality.

The pivot process will not just improve patient flow in the ED, it will also reduce time patients spend in the department, improve patient experience and help patients get the care they need quicker.

Featured image (left to right): Janet Leung, Dr Loren Sher, Trisha Abbey, Janice Fernandes.