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Opinion: Hospitals’ new emergency department triage systems boost profits but compromise care

When it comes to the new provider-in-triage system in emergency departments, there's a palpable feeling among physicians that they are practicing fast-and-loose medicine.
The provider-in-triage model was created by health care consultants who applied the Toyota model of lean production to health care.

If you’ve needed emergency care in the last few years, you probably encountered this situation: Soon after entering the emergency department, you were asked to go to a triage area in the waiting room where a doctor, nurse practitioner, or physician assistant asked you a few questions and ordered some diagnostic tests while you waited.

That’s a departure from the traditional form of triage, in which a nurse assesses the level of acuity of a patient’s illness or injury. This basic and time-honored system ensures that someone with a gunshot wound gets seen before someone with a sprained ankle.

The new “provider-in-triage” system ostensibly accelerates care. On the surface, ordering tests in the waiting room to get the ball rolling might seem like a good way to save time. A closer look reveals a system that sacrifices medical care for hospital profits.

Approximately will visit an emergency department

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