• Title/Summary/Keyword: Triage System

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Development of a Computerized Telephone Triage and Consultation System for Patients Discharged with Ophthalmic Disease (눈질환자의 퇴원 후 증상관리를 위한 전화상담 전산 Triage 시스템 개발)

  • Lee, Hyun Jung
    • Journal of East-West Nursing Research
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    • v.18 no.2
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    • pp.95-103
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    • 2012
  • Purpose: This methodological study was done to develop a computerized telephone triage and consultation system for patients discharged with ophthalmic disease in order to provide more efficient practice guidelines for nurses, and evaluate the usability of the system. Methods: Development of the system consisted of six phases: strategic planning, analysis, design, implementation, evaluation, modification, and maintenance. Results: In the strategic planning phase, ophthalmic problems and nursing interventions of triage algorithms and practice guidelines were cross-mapped with the Omaha system. In the analysis phase, users requirements were identified. Then infrastructure including database, nursing knowledge base, and user interface were designed in the implementation phase. Usability and satisfaction of the system presented as very positive. Telephone consultation took about 2 minutes less than time in the previous system. The system was modified based on users' comments during the evaluation phase. Conclusion: This study was the first attempt in Korea to develop computerized triage system to prompt the quality of telephone consultation. It is suggestive that the computerized triage system may improve the quality of nursing.

Comparison of knowledge level of triage in 119 EMTs (119 구급대원의 중증도 분류 지식 정도 및 교육 전·후 비교)

  • Lee, Hyo-Ju;Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.1
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    • pp.43-54
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    • 2014
  • Purpose : The purpose of this study was to provide appropriate direction for triage education by investigating the knowledge level of triage in 119 EMTs before and after the triage education. Methods : The questionnaire was filled out by newly assigned 33 EMTs in the fire service academy in I metropolitan city from November 1, 2013. The data were analyzed using SPSS WIN 21.0 program. Results : The lowest knowledge level by 119 triage was the potential emergency related question, but that by case-based triage was the semi-emergency related questions. The knowledge score by case-based triage before education was 51.14 points. This was lower than knowledge score by 119 triage, that is, 75.70 points. After education, the knowledge level by 119 triage was significantly improved(p =.000). However, there was no significant difference in the knowledge level by case-based triage(p =.236). Conclusion : It is necessary to provide systematic and periodic education and training for 119 EMTs toward triage to improve triage accuracy and efficient circulation of the emergency medical service system. Especially, it is very important to provide case-based triage education for field application.

Study on Automatic Bug Triage using Deep Learning (딥 러닝을 이용한 버그 담당자 자동 배정 연구)

  • Lee, Sun-Ro;Kim, Hye-Min;Lee, Chan-Gun;Lee, Ki-Seong
    • Journal of KIISE
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    • v.44 no.11
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    • pp.1156-1164
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    • 2017
  • Existing studies on automatic bug triage were mostly used the method of designing the prediction system based on the machine learning algorithm. Therefore, it can be said that applying a high-performance machine learning model is the core of the performance of the automatic bug triage system. In the related research, machine learning models that have high performance are mainly used, such as SVM and Naïve Bayes. In this paper, we apply Deep Learning, which has recently shown good performance in the field of machine learning, to automatic bug triage and evaluate its performance. Experimental results show that the Deep Learning based Bug Triage system achieves 48% accuracy in active developer experiments, un improvement of up to 69% over than conventional machine learning techniques.

Healthcare Process Pattern Analysis with Triage in the Emergency Department (환자의 중증도 분류를 고려한 응급실의 진료 프로세스 패턴 분석)

  • Sim, Seungbae;Choi, Jaehyung;Kim, Bosung;Oh, Jisoo;Kim, Seungho;Park, Yooseok;Park, Incheol;Chung, Taenyoung;Oh, Kyounghwan;Jeong, Bongju;Lee, Young Hoon
    • Journal of the Korean Operations Research and Management Science Society
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    • v.37 no.4
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    • pp.111-124
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    • 2012
  • Emergency room process is very important in the whole hospital processes because it is first diagnosis for patient. Above all, triage is important activity which quickly diagnose the status of emergency patient and sets the priority for treatment. This paper analyzes the treatment process pattern by triage type. The results show that the treatment process after triage such as residence time, diagnosis and checkup type, and joint treatment are dependent on triage types. We can use these analysis results for improving the current triage system and developing the new triage system considering a domestic emergency medical service environment.

Comparison with in-hospital Korean Triage and Acuity Scale (KTAS) and prehospital triage system in a metropolitan city (일개 대도시의 병원전 단계와 병원 단계의 중증도 분류체계 간의 결과 분석)

  • Choi, Hyo Jeong;Kim, Ho Jung;Lee, Hyo Ju;Lee, Bo Ra
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.391-398
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    • 2018
  • Objective: This study was conducted to analyze and compare the classifications of a prehospital triage system and an in-hospital triage system. Methods: The records of patients transferred from the '119' emergency service for 5 months (from January 1 to May 31, 2016) were collected and records of first aid activities were assessed. We examined cases classified as four (urgent, semi-urgent, potentially urgent, and non-urgent) of five stages, excluding death. In the hospital, data were collected from medical records and classifications made using the five Korean Triage and Acuity Scale (KTAS) stages (1, resuscitation; 2, emergency; 3, urgent; 4, less urgent; and 5, non-urgent) were analyzed. Results: The number of patients enrolled in the study was 3,457. Of them, 2,301 were discharged after treatment and 1,156 were hospitalized. According to the prehospital triage classification, 726 of the 3,457 cases were urgent, 593 were semi-urgent, 1,944 were potentially urgent, and 194 were non-urgent. The results of the in-hospital triage were as follows: 114 KTAS 1 (3.3%), 491 KTAS 2 (14.2%), 1,345 KTAS 3 (38.9%), 1,227 KTAS 4 (35.5%), and 280 KTAS 5 (8.1%). The odds ratio trend for hospitalization showed a larger decrease according to in-hospital staging (95% CI, 0.32-0.39) than according to prehospital staging (95% CI, 0.50-0.60). The odds ratio trend for intensive care unit (ICU) admission also showed a larger decrease according to in-hospital staging (95% CI, 0.16-0.22) than according to prehospital staging (95% CI, 0.37-0.48). Conclusion: We found little correspondence in classifications made according to the KTAS and prehospital triage systems. However, the tendencies toward decreases in the hospitalization and ICU admission rates were similar.

Research of IoT concept implemented severity classification system (IoT개념을 활용한 중증도 분류 시스템에 관한 연구)

  • Kim, Seungyong;Kim, Gyeongyong;Hwang, Incheol;Kim, Dongsik
    • Journal of the Society of Disaster Information
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    • v.14 no.1
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    • pp.28-35
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    • 2018
  • The following research has focused and implemented on designing a system that classifies the severity of mass casualty situations across both normal and disaster levels. The system's algorithm has implemented requirements such as accuracy as well as user convenience. The developed e-Triage System has applied various severity classification algorithms implemented from IoT concepts. In order to overcome flaws of currently used severity classification systems, the e-Triage System used electronic elements including the NFC module. By using the mobile application's severity classification algorithm the system demonstrated quick and accurate assessment of patient. Four different LED lamps visualized the severity classification results and RTS scores were portrayed through FND(Flexible Numeric Display) after a two wave classification.

The Suitability of the CDC Field Triage for Korean Trauma Care

  • Choi, Kang Kook;Jang, Myung Jin;Lee, Min A;Lee, Gil Jae;Yoo, Byungchul;Park, Youngeun;Lee, Jung Nam
    • Journal of Trauma and Injury
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    • v.33 no.1
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    • pp.13-17
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    • 2020
  • Purpose: Accurate and appropriate prehospital field triage is essential for a trauma system. The Korean trauma system (established in 2014) uses the trauma field triage algorithm of the United States Centers for Disease Control and Prevention (CDC). This study evaluated the suitability of the CDC field triage criteria for major trauma cases (injury severity score >15) in Korea. Methods: This retrospective cohort study evaluated trauma patients who presented at the authors' regional trauma center from January 1 to May 7, 2017. The undertriage and overtriage rates of each CDC field triage step were calculated. Receiver operating characteristic curves were constructed, and the area under the curve (AUC) was evaluated for each step. Results: Among the 1,009 enrolled patients, 168 (16.7%) had major trauma. The undertriage/overtriage rates of each step (steps I, II, III, and IV) of CDC field triage were 9.2%/47.4%, 6.3%/50.8%, 4.5%/59.4%, and 5.3%/78.9%, respectively. The AUC values of each CDC triage step were 0.722, 0.783, 0.791, and 0.615, respectively. The AUC values of the separate components of each step (physiologic criteria, anatomic criteria, mechanism-of-injury criteria, and special considerations) were 0.722, 0.648, 0.647, and 0.456, respectively. Conclusions: The CDC field triage system is acceptable, but not ideal, for Korean trauma care. If we follow the protocol, it would be preferable to omit step IV. The Korean Triage and Acuity Scale may be a good indicator for in-hospital triage. However, a new triage protocol that is simple to estimate on-scene while having good performance should be developed.

Comparison of KTAS(Korean Triage and Acuity Scale) results by Triage Classifier (중증도 분류자 직종에 따른 중증도 분류 결과의 차이 비교)

  • Huh, Young-Jin;Oh, Mi-Ra;Kim, Se-Hyung;Han, So-Hyun;Pak, Yun-Suk
    • Journal of Convergence for Information Technology
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    • v.10 no.4
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    • pp.98-103
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    • 2020
  • The purpose of this study was to determine whether the results of KTAS(Korean Triage and Acuity Scale) triage classifier differ according to the occupations. We analyzed a total of 10,960,359 cases of data sent to the NEDIS from January 1st, 2016 to December 31th, 2017. The triage classifier were MD(Medical Doctor), R(Resident), INT(Intern), GP(General Practitioner), RN(Registered Nurses) and EMT(Emergency Medical Technician). The consistency between the initial triage and final triage results was the highest GP(98.9%) and the lowest INT(80.2%). The results of over-triage classification was the lowest by GP(0.6%) and the highest for INT(16.0%). Also, the results of under-triage classification was the lowest by MD, EMT(0.4%) and the highest for INT(3.8%). The results of KTAS triage classifier significantly differ from according to the occupations(p<0.001). Triage classification should not differ from according to occupations and skill. It is necessary to strengthen the classifier's capacity for accurate triage classifications.

Severity of Emergency Patient classified by Triage System (중증도 분류체계를 이용한 중증도분류(Triage))

  • Bae, Jung-Hee;Sohn, Sue-Kyung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.7 no.2
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    • pp.264-274
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    • 2001
  • About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

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Impact of nonphysician, technology-guided alert level selection on rates of appropriate trauma triage in the United States: a before and after study

  • Megan E. Harrigan;Pamela A. Boremski;Bryan R. Collier;Allison N. Tegge;Jacob R. Gillen
    • Journal of Trauma and Injury
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    • v.36 no.3
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    • pp.231-241
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    • 2023
  • Purpose: Overtriage and undertriage rates are critical metrics in trauma, influenced by both trauma team activation (TTA) criteria and compliance with these criteria. Analysis of undertriaged patients at a level I trauma center revealed suboptimal compliance with existing criteria. This study assessed triage patterns after implementing compliance-focused process interventions. Methods: A physician-driven, free-text alert system was modified to a nonphysician, hospital dispatcher-guided system. The latter employed dropdown menus to maximize compliance with criteria. The preintervention period included patients who presented between May 12, 2020, and December 31, 2020. The postintervention period incorporated patients who presented from May 12, 2021, through December 31, 2021. We evaluated appropriate triage, overtriage, and undertriage using the Standardized Trauma Assessment Tool. Statistical analyses were conducted with an α level of 0.05. Results: The new system was associated with improved compliance with existing TTA criteria (from 70.3% to 79.3%, P=0.023) and decreased undertriage (from 6.0% to 3.2%, P=0.002) at the expense of increasing overtriage (from 46.6% to 57.4%, P<0.001), ultimately decreasing the appropriate triage rate (from 78.4% to 74.6%, P=0.007). Conclusions: This study assessed a workflow change designed to improve compliance with TTA criteria. Improved compliance decreased undertriage to below the target threshold of 5%, albeit at the expense of increased overtriage. The decrease in appropriate triage despite compliance improvements suggests that the current criteria at this institution are not adequately tailored to optimally balance the minimization of undertriage and overtriage. This finding underscores the importance of improved compliance in evaluating the efficacy of TTA criteria.