Eliminate triage ratings 4&5: Triage system to be ratings 1,2,3, GP

Eliminate triage ratings 4&5: Triage system to be ratings 1,2,3, GP.

Walk-ins:

Currently when a person arrives into the Emergency Department, an assessment is carried out to see how ill they are. From this they given a rating from 1 to 5.

Perhaps the ratings 1 to 5 can be adjusted from 1 to GP.

If the ‘potentially serious patient’ component is removed from the current rating 4, this leaves the following components left (from both ratings 4 & 5):

(rating 4) less severe symptoms or injuries, such as foreign body in the eye, sprained ankle, migraine or ear ache;

(rating 5) less urgent patients: minor illnesses or symptoms, rashes, minor aches and pains.

The idea is that these less severe symptoms and less urgent patients be provided with a standard letter to present to their GP.

The letter may outline the following:

  • This person has presented to hospital with (the issue).
  • This does not fall within the Emergency Department’s need for urgent care to a critically unwell patient.
  • We have recommended this patient present to their GP for less urgent attention required.
  • We ask for consideration that this patient be bulk-billed.

The elimination of ratings or categories 4 & 5 may also have a positive impact on (NEAT).

Ambulance:

To minimise QAS being despatched to a ‘rating GP’, the Call Taker works with a triage system in alliance with the Emergency Department’s triage system 1 to GP.

If triaged as a rating GP and QAS therefore not despatched, that the caller be redirected to 13HEALTH or their own GP.  

 

Why the contribution is important

 

Working in a hospital setting in excess of 10 years (including approximately 6 years within various Emergency Departments) has seen me observe many inappropriate presentations to the Emergency Departments and the impact on both patients and ED staff. 

I believe this idea with the appropriate media exposure and public education has the potential to decrease our instinctual urge to present to an ED if we know our minor illness will not be addressed by an ED doctor.

It also has the potential to: 

  • Significantly reduce a person's waiting time if given a letter once categorised as a ‘rating GP’.
  • Enables sufficient time to visit their GP and or make an appointment.
  • Reduces risk of acquiring an infection within the hospital environment/waiting room.
  • Reduces overcrowding in the ED and waiting room.
  • Improves NEAT (with ratings now reduced to 1,2,&3).
  • Real time education around when we can and cannot present to an ED.
  • Eventual increase in hospital avoidance

 

by Hutleyn on August 15, 2019 at 06:02PM

Current Rating

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Average score : 3.0
Based on : 3 votes

Comments

  • Posted by mcrice August 15, 2019 at 20:10

    "We ask for consideration that this patient be bulk-billed" is the problem with this.

    Rather than "bulk-billed" I ask you to recommend an appropriate dollar value for such a service, considering the savings to the ED that would result. And explore a business case to see how a fair and reasonable fee might be funded.

    I suspect that your model might be hoping for a zero-sum outcome on both sides: ED budgets unchanged (but caseload reduced) and GP funding model unchanged (with caseload increased).

    The current models of care (including funding models) are perfectly designed to produce the outcomes they produce. If Medicare rebates were adequate to support the service model you envisage - it would have been done.

    Disruptive change in funding design is required: in EDs and in GP.
    Let's hear some specifics.
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