The New ER Fad
The fad of the day in the ER is some form of Provider is triage, Rapid Medical Screening or whatever name admin can come up with. In their endless search to increase business we are now catering to the very business that is bankrupting us, the med-i-caid or indigent self-pay people that rarely pay their bill. Hospitals are dedicating rooms to prompt care to increase the speed at which we see the dental pain, back pain, cold symptoms crowd while the sicker people, who are having oh, say an emergency are still waiting in the lobby for a bed to open up.
Agreed!! and, I hear you too ER Murse:
The fundmental problem with Provider is Triage where the "Provider" is a midlevel is that the care is biased towards the low acuity patient. The midlevel does not categorize patients correctly in many cases. They get in over their heads when the main ED gets busy and tend to see patients they should not be seeing to help out rather than have the patient wait. Both Provider is Triage and Zero Wait ED's or Triage Bypass plans tend to get rid of an effective Triage systems and once beds are full +1 then there is frequently not an effective way to safetly priortize patients because Triage has been eliminated and the staff are assigned elsewhere. Then the system of prioritizing falls back to first come first serve with higher acuity patients in low acuity areas and low acuity patients in high acuity areas. Yes its a fad and a dangerous one.
Couldn't have said it better myself...