title: A simplified trauma triage system safely reduces overtriage and improves provider satisfaction: a prospective study.
abstract: BACKGROUND
  Standard triage systems result in high rates of overtriage to achieve acceptably low undertriage. We previously validated optimal triage variables and used these to implement a new simplified triage system (NEW) at our hospital.
  
  
  METHODS
  All trauma entries from May 2010 to Feb 2013 were prospectively reviewed. Calculation of the undertriage and overtriage rates was based on the need for any urgent or life-saving intervention.
  
  
  RESULTS
  We identified 704 trauma patients. Level 1 activations were reduced from 32% (OLD) to 19% in the NEW system (P < .05). Overtriage was reduced from 79% (OLD) to 44% in the NEW system (P < .01). The undertriage rate was 1.6% in the NEW system, compared with 1.2% in the OLD system (P = nonsignificant). Of all patients, 14% (63) required a life-saving intervention. There were no deaths among undertriaged patients.
  
  
  CONCLUSIONS
  The NEW simplified triage system significantly reduced the rate of overtriage, while safely maintaining a low undertriage rate.
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA.
authors.forename: Robert R
authors.initials: RR
authors.lastname: Shawhan
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA.
authors.forename: Derek P
authors.initials: DP
authors.lastname: McVay
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Casey
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA.
authors.forename: Tara
authors.initials: T
authors.lastname: Spears
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Steele
authors.affiliation: Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA; Department of Surgery, Legacy Emanuel Medical Center, Portland, OR, USA. Electronic address: matthew.j.martin16.mil@mail.mil.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Martin
mesh_terms: D000328:Adult; D000465:Algorithms; D005260:Female; D006801:Humans; D008297:Male; D010549:Personal Satisfaction; D011446:Prospective Studies; D014193:Trauma Centers / Q000458:organization & administration*; D015599:Trauma Severity Indices; D014218:Triage / Q000592:standards*; D014947:Wounds and Injuries / Q000175:diagnosis*
keywords: Overtriage; Trauma system; Trauma triage; Undertriage