What is orthopaedic triage? A systematic review

Joanne Morris, Rebecca James, Rachel DAVEY, Gordon WADDINGTON

    Research output: Contribution to journalArticle

    11 Citations (Scopus)

    Abstract

    Rationale, aims and objectives Complex and chronic disease is placing significant pressure on hospital outpatient departments. Novel ways of delivering care have been developed recently and are often described as 'triage' services. This paper reviews the literature pertaining to definitions and descriptions of orthopaedic/musculoskeletal triage processes, in order to provide information on 'best practice' to assist health care facilities. Method A comprehensive open-ended search was conducted using electronic databases to identify studies describing models of triage clinics for patients with a musculoskeletal/orthopaedic complaint, who have been referred to hospital outpatient clinics for a surgical consultation. Studies were critically appraised using the McMaster quality appraisal tool and ranked using the National Health and Medical Research Council hierarchy of evidence. A thematic analysis of the definitions, processes and procedures of triage described within the literature was undertaken. Results 1930 studies were identified and 45 were included in the review (including diagnostic and evaluative research). The hierarchy of evidence ranged from I to IV; however, the majority were at low levels of evidence and scored poorly on the critical appraisal tool. Three broad themes of triage were identified: presence of a referral, configuration of the triage (who, how and where) and the aim of triage. However, there were significant inconsistencies across these themes. Conclusions This systematic review highlighted the need for standardization of the definition of triage, the procedures of assessment and management and measures of outcome used in orthopaedic/musculoskeletal triage to ensure best-practice processes, procedures and outcomes for triage clinics.
    Original languageEnglish
    Pages (from-to)128-136
    Number of pages9
    JournalJournal of Evaluation in Clinical Practice
    Volume21
    Issue number1
    DOIs
    Publication statusPublished - 2014

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    Triage
    Orthopedics
    Practice Guidelines
    Referral and Consultation
    Hospital Outpatient Clinics
    Health Facilities
    Hospital Departments
    Biomedical Research
    Chronic Disease
    Outpatients
    Outcome Assessment (Health Care)
    Databases
    Delivery of Health Care
    Pressure

    Cite this

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    title = "What is orthopaedic triage? A systematic review",
    abstract = "Rationale, aims and objectives Complex and chronic disease is placing significant pressure on hospital outpatient departments. Novel ways of delivering care have been developed recently and are often described as 'triage' services. This paper reviews the literature pertaining to definitions and descriptions of orthopaedic/musculoskeletal triage processes, in order to provide information on 'best practice' to assist health care facilities. Method A comprehensive open-ended search was conducted using electronic databases to identify studies describing models of triage clinics for patients with a musculoskeletal/orthopaedic complaint, who have been referred to hospital outpatient clinics for a surgical consultation. Studies were critically appraised using the McMaster quality appraisal tool and ranked using the National Health and Medical Research Council hierarchy of evidence. A thematic analysis of the definitions, processes and procedures of triage described within the literature was undertaken. Results 1930 studies were identified and 45 were included in the review (including diagnostic and evaluative research). The hierarchy of evidence ranged from I to IV; however, the majority were at low levels of evidence and scored poorly on the critical appraisal tool. Three broad themes of triage were identified: presence of a referral, configuration of the triage (who, how and where) and the aim of triage. However, there were significant inconsistencies across these themes. Conclusions This systematic review highlighted the need for standardization of the definition of triage, the procedures of assessment and management and measures of outcome used in orthopaedic/musculoskeletal triage to ensure best-practice processes, procedures and outcomes for triage clinics.",
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    What is orthopaedic triage? A systematic review. / Morris, Joanne; James, Rebecca; DAVEY, Rachel; WADDINGTON, Gordon.

    In: Journal of Evaluation in Clinical Practice, Vol. 21, No. 1, 2014, p. 128-136.

    Research output: Contribution to journalArticle

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