Accident & Emergency (A&E)
Introduction
The Accident and Emergency (A&E) services are provided at 18 public hospitals under the Hospital Authority (HA). They deliver a high standard of service for critically ill or injured persons who need urgent medical attention. They also provide medical support for victims of disasters.To ensure that patients with more serious conditions are accorded higher priority in medical treatment, HA adopts a triage system which classifies patients attending the A&E Departments into five categories according to their clinical conditions: critical, emergency, urgent, semi-urgent or non-urgent. Patients who do not require emergency attendance should seek medical treatment in public or private clinics.
Triage System
What is Triage? Triage - French word meaning "to sort" or "to choose". It is a process of setting priorities for treatments for a patient or a group of A&E patients. The sorting of patients into priority categories is performed by an experienced registered nursing staff. They use systemic and scientific methods to assess patients' condition to interpret the clinical features and then exercise interventions in the early phase to prevent deterioration and death.The triage system has already been implemented in all A&E Departments to help determine the relative priority of individual patient needs. Emergency patients will be given immediate treatment, while those with non-acute symptoms should expect a longer waiting time.
When patients arrive at the A&E Department, they will first be assessed by an experienced and specially trained triage nurse according to the severity and nature of their medical conditions, and priority will be given to urgent cases.
Patients are divided into five categories according to their medical condition -
- critical
- emergency
- urgent
- semi-urgent
- non-urgent
For critical patients who are dying or in life-threatening condition, they are accorded top priority and attended immediately by a team of medical and nursing staff without waiting.
Objectives of Triage
- Ensure early recognition and assessment of patients' condition and prioritize the treatment according to severity of the conditions
- Reduce unnecessary delay of treatment
- To give brief First-Aid advice
- Initiate immediate diagnostic tests, intervention and nursing treatment
- Allow effective utilization of staff and resources by allocating patients to appropriate treatment area according to their conditions
- improve patient-staff relationship and departmental image through greeting and communication during process of triage
- Promote public relationship by immediate interview with patient
- Enable direct communication with pre-hospital care provider
- Provide documentation patients' condition, time of triage and preliminary treatment given in triage
- To provide staff training and decision making
Service Targets
For patients whose clinical conditions are triaged as Category I to III, HA has set performance pledges on the waiting time for their treatment.- Triage Category I (critical cases): Immediate treatment
- Triage Category II (emergency cases): 95% of patients triaged as emergency will be treated within 15 minutes
- Triage Category III (urgent cases): 90% of patients triaged as urgent will be treated within 30 minutes