Improving the Prompt Identification of the Emergency Severity Index Level 2 Patient in Triage: Rapid Triage and the Registered Nurse Greeter

IntroductionHigh triage volumes can delay rapid identification of walk in ESI level 2 patients. This concern coupled with persistently increasing volumes prompted the Reading Hospital Emergency Department to move from single-tiered triage to duel-tiered rapid triage in 2008, then brought the addition of the RN Greeter in 2011. The purpose of this study was to assess how rapid triage then the RN Greeter impacted the ability to quickly identify the walk-in ESI 2 patient.MethodsA retrospective analysis of mini-registration to triage time was conducted on ESI level 2 patients entering the ED by means other than ambulance. Data was collected from three separate time frames: The first representing single-tiered triage, the second duel-tiered rapid triage, and the third duel-tiered triage with the RN Greeter.ResultsData demonstrated despite increasing volumes both rapid triage and the RN Greeter improved the prompt identification of ESI 2 patients.DiscussionWhile moving from single to duel-tiered triage met little resistance from staff, the RN Greeter role was initially not as well received. However, as empirical data demonstrated the efficacy of the RN Greeter to quickly identify the potential ESI 2 patient, the role ultimately became an integral part of triage.