• Robert R Shawhan, Derek P McVay, Linda Casey, Tara Spears, Scott R Steele, and Matthew J Martin.
• Department of Surgery, Madigan Army Medical Center, 9040-A Fitzsimmons Drive, Tacoma, WA 98431, USA.
• Am. J. Surg. 2015 May 1;209(5):856-62; discussion 862-3.

BackgroundStandard triage systems result in high rates of overtriage to achieve acceptably low undertriage. We previously validated optimal triage variables and used these to implement a new simplified triage system (NEW) at our hospital.MethodsAll trauma entries from May 2010 to Feb 2013 were prospectively reviewed. Calculation of the undertriage and overtriage rates was based on the need for any urgent or life-saving intervention.ResultsWe identified 704 trauma patients. Level 1 activations were reduced from 32% (OLD) to 19% in the NEW system (P < .05). Overtriage was reduced from 79% (OLD) to 44% in the NEW system (P < .01). The undertriage rate was 1.6% in the NEW system, compared with 1.2% in the OLD system (P = nonsignificant). Of all patients, 14% (63) required a life-saving intervention. There were no deaths among undertriaged patients.ConclusionThe NEW simplified triage system significantly reduced the rate of overtriage, while safely maintaining a low undertriage rate.Published by Elsevier Inc.

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