Adult Triage in the Emergency Department. Introducing a Multi-Layer Triage System

Emergency Department (ED) Triage is the cornerstone of ED operations. Many different triage systems have been proposed and implemented globally. To date an ideal triage system has not been identified. As the burden on ED’s rises with overcrowding being recognized as a universal problem ED triage needs to restructure to address this reality. Extensive and critical of the literature has identified the strengths and weaknesses of current ED triage implementations. A novel multi-layer triage system was introduced and implemented in Greek ED's combining the strengths of various triage and Early Warning Systems and scores, in an effort to minimize under-triage and the adverse downstream effects that in creates on patient outcomes. In its years of implementation, it has proven to be fast, accurate, objective, and reproducible. Acknowledging that no triage system can be universally adapted in different settings, that the structural concepts of this triage system address most of the triage problems currently reported in the literature.