title: Impact of an ABCDE team triage process combined with public guidance on the division of work in an emergency department.
abstract: OBJECTIVE
  To study the effects of applying an emergency department (ED) triage system, combined with extensive publicity in local media about the "right" use of emergency services, on the division of work between ED nurses and general practitioners (GPs).
  
  
  METHODS
  An observational and quasi-experimental study based on before-after comparisons.
  
  
  METHODS
  Implementation of the ABCDE triage system in a Finnish combined ED where secondary care is adjacent, and in a traditional primary care ED where secondary care is located elsewhere.
  
  
  METHODS
  GPs and nurses from two different primary care EDs.
  
  
  METHODS
  Numbers of monthly visits to different professional groups before and after intervention in the studied primary care EDs and numbers of monthly visits to doctors in the local secondary care ED.
  
  
  RESULTS
  The beginning of the triage process increased temporarily the number of independent consultations and patient record entries by ED nurses in both types of studied primary care EDs and reduced the number of patient visits to a doctor compared with previous years but had no effect on doctor visits in the adjacent secondary care ED. No further decrease in the number of nurse or GP visits was observed by inhibiting the entrance of non-urgent patients.
  
  
  CONCLUSIONS
  The ABCDE triage system combined with public guidance may reduce non-urgent patient visits to doctors in different kinds of primary care EDs without increasing visits in the secondary care ED. However, the additional work to implement the ABCDE system is mainly directed to nurses, which may pose a challenge for staffing.
authors.affiliation: Attendo LTD , Helsinki , Finland.
authors.forename: Jarmo
authors.initials: J
authors.lastname: Kantonen
authors.forename: Robert
authors.initials: R
authors.lastname: Lloyd
authors.forename: Juho
authors.initials: J
authors.lastname: Mattila
authors.forename: Timo
authors.initials: T
authors.lastname: Kauppila
authors.forename: Ricardo
authors.initials: R
authors.lastname: Menezes
mesh_terms: D000553:Ambulatory Care / Q000458:organization & administration; D003695:Delivery of Health Care; D004636:Emergency Service, Hospital; D005387:Finland; D058005:General Practitioners; D006801:Humans; D009726:Nurses; D009819:Office Visits; D010348:Patient Care Team; D010353:Patient Education as Topic; D010561:Personnel Staffing and Scheduling; D011320:Primary Health Care; D063127:Secondary Health Care; D014218:Triage / Q000458:organization & administration; D014937:Work
keywords: Emergency department; Finland; general practice; patient grouping; primary care; reverse triage; triage