Medicinsk triage på akutmottagningen; en beskrivning av patientgrupper i olika triagenivåer samt potentiella snabbspår i RETTS.

Sammanfattning: Medical triage systems have gone through rapid development during the 1990s and 2000s. Today (2015), all of the Swedish hospitals and county councils employ the triage system RETTS at their emergency departments (ED). The processes at the emergency department need to allow for high variability as wells as high volume. Triage systems can be thought of as a process comparable to cellular processes in operations management theory. Cellular processes allow for separation of processes with different variability-­-volume-­-characteristics. Application in healthcare could allow for a higher cost efficiancy since high process variability not neccesary is needed in every patient group. However, RETTS 's potential in cellular process design isn´t fully utilized to day. There´s a need for a survey regarding common presenting complaints, vital parameters and age distribution as a mean for further process separation and accomodation with regards to variability and volume characteristics in different patient groups. A survey of that kind might identify potential separate cellular processes, i.e. fast tracks as a mean of reducing patient volumes in processes with higher variability demand. This study includes 39 913 patient visits at a Swedish medium sized ED. The top 50 presenting complaints, as well as age distributions, are presented for each triage level as a mesaure of variability in order to evaluate the possibility of implemention of cellular processes at the ED and therefore lower costs and raise patient safety. Also, evidence of the "McDonalds effect" with a high volume of ED-­-visits in the age group of 18 to 30 years is described and discussed further with focus on cellular process design.