Triage Out at the Emergency Departments: Evaluation of the French Work Practices

Aim: Frequent overcrowding of emergency departments (EDs) leads to the development of the practice of triage out, which is not subject to any formal recommendation in France. The aim of this study was to describe the French physicians habits about redirecting their patients out from the ED. Procedure: This was a retrospective, descriptive, multicentric study. A survey available online was sent to the 26 French university hospital EDs. Results: A total of 169 emergency physicians answered to the survey, 141 (83%) of them reported practicing triage out and 37 (26%) rely their decisions with data from the literature. There were fewer than 5 patients per day for 92 physicians (65%). One-hundred and six physicians (75%) reported redirecting patients to their general practitioner, 88 (62%) to general medicine departments, and 36 (25%) to their home. Most of the physicians refusing triage suffer from ED pressure, lack of local solutions, and fear of medico-legal issues. Ninety physicians (54%) had a hospital policy shift about triage out, positive in 90% of cases. Conclusion: Triage out in France is a usual practice, suffering from lack of supervision and official recommendations.