Interview with Dr. Jeremy Ackerman
From Emergency Room of the Future
Triage from an MD Perspective
Notes from interview with Jeremy Ackerman, MD, PhD - conducted by Brandon Thompson 16 Oct 08
- Approximately 20% of patients can be discharged after triage if seen by a Phycisian.
- There are certain triggers that Triage Nurses will use in order to conduct test such as EKGs. EKGs are the most common test performed at Triage. There is a 10 minute door-to-EKG standard. This requires the capability to perform EKGs at Triage if ER treatment rooms are usually full.
- Triage Nurses typically have other responsibilities. The most common additional duty is observing the Waiting Room. However, most ER Triage areas are poorly designed and observation of the waiting room is restricted or impossible when a nurse is conducting triage.
- Registration cannot interfer with treatment. Registration in the ER is usually performed during natural gaps or breaks during treatment. Dr. Ackerman recommends that registration be performed by registration clerks walking around with clipboards who see patients after triage while they are waiting for a treatment room or test results or see the patients in the treatment rooms in between nurse or physician treatment.
- Dr. Ackerman stated that an eye chart is necessary in the Triage area. He said many triage areas do not have room for the 10 foot eye test so they use an alternate 24 inch test (hand held card as opposed to an eye chart on the wall).
- There is no benefit for certain procedures such as sutures to be performed in the traige area. Triage is to sort patients and identify priority of patient care.