RESUMO
PURPOSE: Because the quality of medical resources is extremely uneven across China, it is nearly impossible to implement a unified emergency triage program. The aim of the study is to examine triage using the "two-step four-level+ " triage model in a hospital in Southern China, with an emphasis on hand, foot, and mouth disease. DESIGN AND METHODS: This was a retrospective study of all patients seen in the pediatric emergency room (ER) between January 1, 2012 and December 31, 2018, at the Guangzhou Women and Children's Medical Center. The "two-step and four-level+ " was manually implemented in 2012, and an electronic triage system was developed and applied since 2015. Emergency quality control indicators were analyzed. RESULTS: There were 645,473 patients triaged at the pediatric ER between January 1, 2015 and December 31, 2018. After the first step, 17,444 patients were classified as unstable, including 6546 (1.01%) Level I patients, 10,898 (1.69%) Level II patients, 210,368 (32.5%) Level III patients, and 417,661 (64.8%) Level IV patients. After triage implementation, the stay time of the patient in the pediatric ER decreased each year (all p < .05) and shortened to 20.3 ± 2.2 h in 2018. Compared with 2012-2014, the mortality of 2015-2018 decreased by 21.1%, the rate of unexpected resuscitation was 0%, and the complaints of overcrowding decreased (all p < .05). PRACTICE IMPLICATIONS: This "two-step four-level+ " triage method can improve the medical care quality of pediatric ER in China.
