title: Doctor at triage - effect on waiting time and patient satisfaction in a Jamaican hospital.
abstract: BACKGROUND
  Waiting time in the Emergency Departments is a major source of patient dissatisfaction in hospitals. Triage attempts to have the most critically ill patients seen first with an overall reduction in waiting time. Triage teams may include specially trained nurses or alternatively a specialist physician. The aim of this study was to determine if inclusion of a specialist physician on the triage team at the University Hospital of the West Indies (UHWI) in Kingston Jamaica reduced waiting time and improved patient satisfaction.
  
  
  METHODS
  A prospective, cross sectional survey of ambulatory care patients was undertaken in 2006. Triage was completed by a team consisting of a doctor and two nurses during the first week and by nurses only during the second week.
  
  
  RESULTS
  The study showed that there was no significant difference in the length of time patients spent in the emergency department based on whether or not they were triaged by a physician led team or by a team of nurses only. Type of triage team did not affect the level of patient satisfaction. Waiting time was significantly influenced by factors which came into play after triage such as the wait for X-ray and laboratory services.
  
  
  CONCLUSIONS
  There appears to be no reduction in waiting times experienced by patients at the UHWI emergency department as a result of inclusion of a specialist emergency physician in the triage process. This suggests that specialist emergency department nurses are adequately trained in triage, and that delays in the triage process at UHWI are due to other factors.
authors.affiliation: Department of Surery, Radiology Anaesthesia and Intensive Care, Jamaica.
authors.forename: Simone
authors.initials: S
authors.lastname: French
authors.affiliation: UWI School of Nursing, The University of the West Indies, Mona, Kingston 7, Jamaica. Electronic address: jascinth.lindo02@uwimona.edu.jm.
authors.forename: Jascinth L M
authors.initials: JL
authors.lastname: Lindo
authors.affiliation: Department of Surery, Radiology Anaesthesia and Intensive Care, Jamaica.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Williams Jean
authors.affiliation: Department of Surery, Radiology Anaesthesia and Intensive Care, Jamaica.
authors.forename: Jean
authors.initials: J
authors.lastname: Williams-Johnson
mesh_terms: D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D006785:Hospitals, University; D006801:Humans; D007563:Jamaica; D008505:Medical Staff, Hospital; D009741:Nursing Staff, Hospital; D010348:Patient Care Team; D017060:Patient Satisfaction; D011446:Prospective Studies; D013997:Time Factors; D014218:Triage; D000078329:Workforce
keywords: Doctor-led triage; Emergency department; Non-urgent; Waiting time