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Emerg Med J. 2006 Apr;23(4):262-5; discussion 262-5.

Triage rapid initial assessment by doctor (TRIAD) improves waiting time and processing time of the emergency department.

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  • 1Accident and Emergency Department, Pamela Youde Nethersole Eastern Hospital, Hong Kong.



To evaluate the effect of triage rapid initial assessment by doctor (TRIAD) on waiting time and processing time of an emergency department (ED) without extra staff.


A senior emergency doctor was put into triage instead of a consultation cubicle for seven shifts of 9 hours each. All the patients were assessed and necessary interventions started at the time of triage. Waiting time and processing time of various categories of patients were compared with a control group that was sampled during the week before the trial period.


In total, there were 1310 cases in the trial period and 1355 controls. Over a quarter (27%) of the patients received triage doctor interventions. The average waiting time was reduced by 38% and the average processing time by 23%. Patients without triage intervention also had a 24% shorter waiting time because of overall improvement in efficiency. Trauma patients and patients needing radiography particularly benefited from the new system. The waiting time and processing time of category 4 and 5 patients improved significantly as a result of more efficient processing of more urgent cases.


The waiting time and processing time of the ED were greatly reduced by TRIAD without extra manpower.

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