Triage for small ER

  1. I work in a small ER and our JACHO inspection is coming soon. Triage for the ER is becoming an issue. We only see approx. 4000-5000 patients a year. We do not get enough patients a day to warrant a traige nurse. How is this handled by other hospitals of this size? I really need suggestions.

  2. Visit kodiaklori profile page

    About kodiaklori

    Joined: Mar '02; Posts: 1
    Emergency Nurse


  3. by   Nanette
    I understand your situation, although not as small as you, we have similar issues, our patients are seen quickly most of the time.

    It's not exactly JCAHO you have to worry about, they are checking how you comply with the EMTALA/COBRA laws.

    You do not have to triage patients all the time. You do have to be sure they are not asked any insurance questions before getting the medical screening exam.

    If you only get basic data,name, birhdate to identify patient prior to care, you are fine.

    We had to change our approach as we registered patients, then brought them back. Now we bring them back, get name, birthdate, attending physician, do a quick register and have the other data collected as time permits during the stay.

    The weird part is by regulations, a patient can sit in the lobby for any length of time if you are busy..... as long as you don't ask them about insurance and you have a plan how to handle the increased census.

    The newest changes in the law says collecting the payment info cannot interfere with care.
    So, if you are busy, the registrar can tell the patient there will be a little wait, would they like to go ahead and register. No law broken. If you become available, the registration should stop and care begin.

    As long as you can verbalize how you see patients before collecting the insurance data AND can state what you do when you get busy [EX: Nursing super comes down to triage patients in lobby while you take care of ones in back, etc..]

    Hope this helps.
    You'll do fine !!
    good luck