NTS versus waiting time: an indicator without definition.
OBJECTIVE
The National Triage Scale versus waiting time is a key performance indicator for Australasian emergency departments. However, the point at which the clock starts to measure waiting time has not been defined. The aim of this study was to determine how this indicator is measured in Australia, as well as a number of other issues relating to the application of the National Triage Scale.


METHODS
A postal survey was sent to the directors of emergency medicine at 147 emergency departments in Australia.


RESULTS
There were 105 responses (71.4%). For measurement of the National Triage Scale versus waiting time indicator, 52 (49.5%) started the clock at the time of patient arrival, 33 (31.4%) at the start of triage, and 11 (10.5%) at the end of triage. Seventy-four emergency departments (70.5%) change the National Triage Scale (NTS) after it has been assigned, and approximately half use set codes for given presentations. Only 28 (26.7%) automatically upgrade children one NTS category. The age definition of a child ranged from 3 years to 18 years.


CONCLUSIONS
The measurement of this key performance indicator is not consistent across Australia. Therefore, caution is advised when comparing such data between departments. The Australasian College for Emergency Medicine should produce operational definitions relating to the use of the National Triage Scale in order to provide meaningful comparative data.
Fatovich
D M
DM
Department of Emergency Medicine, Royal Perth Hospital, Western Australia, Australia. daniel.fatovich@health.wa.gov.au
Jacobs
I G
IG
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001315:Australia; D002648:Child; D002675:Child, Preschool; D003625:Data Collection / Q000379:methods*; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D017748:Time Management; D014218:Triage / Q000458:organization & administration / Q000592:standards*; D014850:Waiting Lists