Reverse triage, or identifying hospitalized patients at low-risk for adverse events and discharging them to increase surge capacity during a sudden influx of patients can be useful in pediatric hospitals, according to new research recently published in the journal JAMA Pediatrics.
While the concept of reverse triage has displayed possible efficacy in studies on adult hospitals, the strategy has not been evaluated in the pediatric hospital setting. To determine whether reverse triage would be helpful in a pediatric hospital during a surge of patients likely caused by a natural disaster or infectious disease pandemic, researchers assessed one year of inpatient data from seven units at the Johns Hopkins Children's Center in Baltimore. Researchers randomly distributed 196 mock disaster days across the data to quantify the possible influence of reverse triage on the hospital's ability to take in new patients.
Researchers determined the implementation of reverse triage would permit the early discharge of 10.8 percent of pediatric patients during the first four days after a mock disaster. The ability to discharge patients varied across units. Researchers found the psychiatry unit could discharge as many as 72.7 percent of patients early, while the oncology unit could discharge only 1.3 percent of patients and the pediatric intensive care unit could discharge none of its patients early.
When excluding the psychiatry unit, researchers found reverse triage could increase surge capacity by 4.8 percent on day one and 7 percent by day four.
"The reverse triage strategy among this pediatric patient population is more limited than previously shown for adults and may be sizably dependent on the psychiatry unit," concluded the study's authors. "However, reverse triage appears to provide a meaningful contribution to creating capacity without requiring incremental resources. Ultimately, such an approach could also offer a safe means to address severe hospital crowding."
More articles on patient flow:
How healthcare utilization differs depending on wage, salary: 5 things to know
Meeting the challenge of the academic mission: Strategies to improve efficiency in academic hospitals' ORs
Waiting sucks: Time to fix healthcare’s other transparency issue