December 14, 2018
Imagine multiple patients arriving to an Emergency Department, and you are the person tasked with making a quick decision on which patients should be seen first. It’s a near impossible task, but everyday nurses must triage patients, sorting them by level of urgency, all while under immense pressure.
In Canada, a group of Emergency Department physicians and nurses developed a solution in the 1990s to help aid their triage decisions: CTAS (Canadian Triage and Acuity Scale). CTAS helps define how long a patient can safely wait to be seen by an ED physician after an initial assessment. The patient is evaluated based on the injury/illness and physiological findings, then ranked by severity of 1-5, whereby 1 is the highest severity and 5 is the lowest.
While CTAS has been beneficial, a 2010 Annual Report of the Office of the Auditor General of Ontario reported that only 37 percent of patients were appropriately triaged in Emergency Departments. Of those that weren’t properly triaged, 38% were found to be under-triaged (underestimating the severity of a patient’s illness or injury).
In response, the Ontario Health Ministry announced it was getting involved and delegated Cancer Care Ontario (CCO) in 2015 to create a solution to facilitate the standardization of how CTAS guidelines are applied in order to improve patient safety.
From CTAS to eCTAS
Enter eCTAS, which stands for Electronic Canadian Triage and Acuity Scale. A triage decision-support system that incorporates CTAS, it was designed by top clinical and technical experts to assist triage nurses in making more accurate assignments of the CTAS score– no matter what their level of experience. Essentially, when a triage nurse utilizing eCTAS enters a patient’s information during documentation, a CTAS score is calculated based on the information provided and the national triage guidelines.
Hospitals can choose to implement the eCTAS solution either through the provincial web application or by incorporating it into their own hospital systems.
Putting eCTAS into Practice
Grand River Hospital in Kitchener, Ontario opted to integrate eCTAS with their Wellsoft EDIS (Emergency Department Information System). Having implemented the industry-leading Emergency Department system in 2017, the Grand River Hospital team was ready to take the next step and move forward with eCTAS certification. Wellsoft and Grand River Hospital teams worked collaboratively for many months before going live this November at the hospital. Fully integrated into the triage process, clinicians are able to use the application to assess, document, calculate the CTAS score and automatically submit the encounter to CCO (with near real-time submission).
eCTAS certification is a gigantic step for Canadian hospitals as they work to improve patient safety through the utilization of best practices for triaging emergency department patients. Congratulations to Grand River Hospital for being the first hospital utilizing Wellsoft EDIS to go-live with eCTAS!
Have any questions on eCTAS? Contact us to let us know and we’ll be in touch shortly.