Simulating the effect of physician triage in the emergency department of Akershus University Hospital

The Norwegian Board of Health Supervision has strongly recommended that all hospitals need to take action to improve the long waiting times before patients are seen by a physician in the Hospital Emergency Department. Akershus University Hospital has complied with this by introducing physician triage every weekday from 10 am to 7 pm. Because it is difficult to see the influence this has had on the patient flow in the ED, the Hospital Research Department has developed two simulation models to estimate the effect on patient waiting time by replacing nurse triage with that of a physician. The results of the simulations show that the waiting time for an initial physician evaluation was reduced from 117 minutes to 26 minutes, while the waiting time for a physician examination was reduced only by 7 minutes. The total waiting time in the ED was reduced from 297 to 288 minutes when introducing physician triage.