Re-engineering an American emergency department with Team Triage - adapting to increasing patient volume in emergency services

Introduction Overcrowding in U.S. emergency departments (ED) is a critical issue. In a privatized health care system, patients with limited access to insurance benefits (as influenced by challenging socio-economic conditions) often utilize the ED as crucial point of access to care. Non-acute patients seeking primary care in ED facilities can congest operations and contribute to overcrowding. In Hawaii’s second busiest ED (Hospital 1), a non-traditional method of emergency triage – team triage – has been implemented to improve patient throughput and satisfaction, and mitigate effects of overcrowding. This study defines trends and compares two prominent and nationally recognized EDs (Hospital 1 and Hospital 2) in the state of Hawaii employing team and traditional triage respectively, to examine changes in patient population, demographics, acuteness, and departmental throughput measures.