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Reverse triage: more than just another method

Pollaris, Gwen; Sabbe, Marc

European Journal of Emergency Medicine: August 2016 - Volume 23 - Issue 4 - p 240–247
doi: 10.1097/MEJ.0000000000000339

Reverse triage is a way to rapidly create inpatient surge capacity by identifying hospitalized patients who do not require major medical assistance for at least 96 h and who only have a small risk for serious complications resulting from early discharge. Electronic searches were conducted in the MEDLINE, TRIP, Cochrane Library, CINAHL, EMBASE, Web of Science, and SCOPUS databases to identify relevant publications published from 2004 to 2014. The reference lists of all relevant articles were screened for additional relevant studies that might have been missed in the primary searches. There will always be small individual differences in the reverse triage decision process, influencing the potential effect on surge capacity, but at most, 10–20% of hospital total bed capacity can be made available within a few hours. Reverse triage could be a response to Emergency Department (ED) crowding, as it gives priority to ED patients with urgent needs over inpatients who can be discharged with little to no health risks. The early discharge of inpatients entails negative consequences. They often return to the ED for further assessment, treatment, and even readmission. When time to a medical referral or bed is less than 4–6 h, 100 additional lives per annum are predicted to be potentially saved. The results of our systematic review identified only a small number of publications addressing reverse triage, indicating that reverse triage and surge capacity are relatively new subjects of research within the medical field. Not all research questions could be fully answered.

Department of Emergency Medicine, University Hospitals Leuven, Leuven, Belgium

Correspondence to Gwen Pollaris, Department of Emergency Medicine, University Hospitals Leuven, Herestraat 49, Leuven B-3000, Belgium Tel: +32 016 34 39 00; fax: +32 016 34 38 99; e-mail:

Received February 17, 2015

Accepted September 21, 2015

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