Triage of referrals to outpatient hepatology services: an ineffective tool to prioritise patients?

Horsfall, Leigh, Skoien, Richard, Moss, Cathy, Scott, Ian, Macdonald, Graeme A. and Powell, Elizabeth E. (2012) Triage of referrals to outpatient hepatology services: an ineffective tool to prioritise patients?. Australian Health Review, 36 4: 443-447. doi:10.1071/AH11111

Author Horsfall, Leigh
Skoien, Richard
Moss, Cathy
Scott, Ian
Macdonald, Graeme A.
Powell, Elizabeth E.
Title Triage of referrals to outpatient hepatology services: an ineffective tool to prioritise patients?
Journal name Australian Health Review   Check publisher's open access policy
ISSN 0156-5788
Publication date 2012-01
Sub-type Article (original research)
DOI 10.1071/AH11111
Volume 36
Issue 4
Start page 443
End page 447
Total pages 5
Place of publication Collingwood, VIC, Australia
Publisher C S I R O Publishing
Collection year 2013
Language eng
Formatted abstract
Background. Appropriate and uniform prioritisation (‘triaging’) of outpatient referrals is critical to good patient outcomes, equity of access to services and efficient use of resources.

Objective. To determine whether there is uniformity in the allocation of triage categories for hepatology outpatient referrals at public hospitals in Queensland.

Methods. A series of 10 recent hepatology referrals were de-identified for both patient and referring clinician details and sent to nine gastroenterology or hepatology centres throughout Queensland. Consultant gastroenterologists and hepatologists (n = 25) were asked to triage the referrals using the process in place in their centre. Responses were de-identified and analysed. Each case was reviewed and allocated an ‘agreed triage category’ based upon the majority view of respondents.

Nineteen responses were received. There was substantial variation amongst consultants in the allocation of triage categories. Although almost two-thirds of respondents agreed with the majority view in 60–80% of cases, none agreed with the majority for every case and some agreed in as few as 50% cases. Disagreement with the majority view of an appropriate triage category was not associated with geography or specialist experience.

Variability in triage categorisation suggests that similar cases may be allocated different priorities by those responsible for determining the urgency of outpatient review. This has implications for equity of access to treatment. The development of triage guidelines and formal training in their implementation, along with periodic audits of triage practices in different centres, may reduce variability.
Keyword Audit
Resource allocation
Service delivery
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
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