Revision of the Protocol of the Telephone Triage System in Tokyo, Japan

Introduction. The Emergency Telephone Consultation Center in Tokyo (#7119) was the first telephone triage system in Japan and has operated since 2007. This study examined the revision of the #7119 protocol by referring the linked data to each code of the triage protocol. Methods. We selected candida...

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Main Authors: Atsushi Sakurai, Jun Oda, Takashi Muguruma, Shiei Kim, Sachiko Ohta, Takeru Abe, Naoto Morimura
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Emergency Medicine International
Online Access:http://dx.doi.org/10.1155/2021/8832192
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author Atsushi Sakurai
Jun Oda
Takashi Muguruma
Shiei Kim
Sachiko Ohta
Takeru Abe
Naoto Morimura
author_facet Atsushi Sakurai
Jun Oda
Takashi Muguruma
Shiei Kim
Sachiko Ohta
Takeru Abe
Naoto Morimura
author_sort Atsushi Sakurai
collection DOAJ
description Introduction. The Emergency Telephone Consultation Center in Tokyo (#7119) was the first telephone triage system in Japan and has operated since 2007. This study examined the revision of the #7119 protocol by referring the linked data to each code of the triage protocol. Methods. We selected candidates based on the medical codes targeted by the revision, linking data from the nurses’ decisions in triage and the patients’ condition severity when the ambulance arrived at the hospital, gathering data from June 1, 2016, to December 31, 2017. Then, several emergency physicians evaluated the cases and decided whether the code should be moved to the more or less urgent category or if new protocols and codes would be established. Results. In this revision, 371 codes were moved to the less urgent category, 35 codes were moved to the more urgent category, and 128 codes were newly established. In all, 59 red codes (transfer to the ambulance dispatcher) were reduced, while 254 orange codes (attendance at hospital within 1 hour) and yellow codes (within 6 hours) were moved to less urgent, and 12 yellow and green codes (within 24 hours) were moved to more urgent. Conclusion. We adjusted the triage codes for the revision by linking the call data with the case data. This revision should decrease the inappropriate use of ambulances and reduce the primary care workload. To achieve a more accurate revision, we need to refine the process of evaluating the validity of patients’ acuity over the telephone during triage.
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spelling doaj-art-42f2cff7f10a4f76b87321b07c063c742025-08-20T03:35:54ZengWileyEmergency Medicine International2090-28402090-28592021-01-01202110.1155/2021/88321928832192Revision of the Protocol of the Telephone Triage System in Tokyo, JapanAtsushi Sakurai0Jun Oda1Takashi Muguruma2Shiei Kim3Sachiko Ohta4Takeru Abe5Naoto Morimura6Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, 30-1 Oyaguchikamichou, Tokyo, JapanDepartment of Emergency and Critical Care Medicine, Tokyo Medical University, Shinjuku City, Tokyo 160-8402, JapanDepartment of Emergency Medicine, Yokohama City University Graduate School of Medicine, Kanazawa Ward, Yokohama City, Kanagawa 236-0027, JapanDepartment of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5, Sendagi, Tokyo, JapanDepartment of Pharmaceutical and Medical Business Sciences, Nihon Pharmaceutical University, 3-15-9 Yushima, Bunkyo City, Tokyo, JapanAdvanced Critical Care and Emergency Center, Yokohama City University Graduate School of Medicine, Kanazawa Ward, Yokohama City, Kanagawa 236-0004, JapanDepartment of Acute Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo City, Tokyo, JapanIntroduction. The Emergency Telephone Consultation Center in Tokyo (#7119) was the first telephone triage system in Japan and has operated since 2007. This study examined the revision of the #7119 protocol by referring the linked data to each code of the triage protocol. Methods. We selected candidates based on the medical codes targeted by the revision, linking data from the nurses’ decisions in triage and the patients’ condition severity when the ambulance arrived at the hospital, gathering data from June 1, 2016, to December 31, 2017. Then, several emergency physicians evaluated the cases and decided whether the code should be moved to the more or less urgent category or if new protocols and codes would be established. Results. In this revision, 371 codes were moved to the less urgent category, 35 codes were moved to the more urgent category, and 128 codes were newly established. In all, 59 red codes (transfer to the ambulance dispatcher) were reduced, while 254 orange codes (attendance at hospital within 1 hour) and yellow codes (within 6 hours) were moved to less urgent, and 12 yellow and green codes (within 24 hours) were moved to more urgent. Conclusion. We adjusted the triage codes for the revision by linking the call data with the case data. This revision should decrease the inappropriate use of ambulances and reduce the primary care workload. To achieve a more accurate revision, we need to refine the process of evaluating the validity of patients’ acuity over the telephone during triage.http://dx.doi.org/10.1155/2021/8832192
spellingShingle Atsushi Sakurai
Jun Oda
Takashi Muguruma
Shiei Kim
Sachiko Ohta
Takeru Abe
Naoto Morimura
Revision of the Protocol of the Telephone Triage System in Tokyo, Japan
Emergency Medicine International
title Revision of the Protocol of the Telephone Triage System in Tokyo, Japan
title_full Revision of the Protocol of the Telephone Triage System in Tokyo, Japan
title_fullStr Revision of the Protocol of the Telephone Triage System in Tokyo, Japan
title_full_unstemmed Revision of the Protocol of the Telephone Triage System in Tokyo, Japan
title_short Revision of the Protocol of the Telephone Triage System in Tokyo, Japan
title_sort revision of the protocol of the telephone triage system in tokyo japan
url http://dx.doi.org/10.1155/2021/8832192
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