Evaluation of a rheumatology patient prioritization triage system

Abstract

Purpose: Patient triage systems have been used to prioritize referred patients to facilitate timely treatment of acutely ill patients, but there is limited data to support the effectiveness of these systems as implemented in the clinic setting. Therefore, the purpose of this study was to evaluate the accuracy of a specialty provider triage system.

Data sources: A prospective study design was conducted (N = 103) to compare the pre- and postappointment provider-assigned, prioritization system acuity scores. The intraclass correlation coefficient (ICC), paired t-test, and the Bland-Altman plotting method were used to summarize and analyze the data.

Conclusions: The ICC between the pre- and postappointment acuity scores was 0.50 (p < .001) with no significant difference between the average means (t = -1.17; p = .24). The Bland-Altman plot suggests scores were typically within the limits of agreement. Our findings suggest the specialty provider triage system was effective at accurately classifying rheumatologic patient acuity in this sample.

Implications for practice: When resources are limited and delayed evaluations and treatments result in negative health outcomes, the use of triage systems is likely an effective strategy to reduce the impact of limited provider availability relative to patient census.

Keywords: Clinical decision making; outpatient; quality improvement; rheumatoid arthritis.

Figure 1

Bland–Altman plot.