Agent-based modelling and simulation of emergency department re-triage

Triage is a process of accessing patients on their severity based on a triage acuity scale in hospital emergency department (ED). Re-triage is a process where the severity of a patient's condition is reassessed when there is a clinical need for it. Re-triage does not feature in the conventional triage, where the patients with non-urgent consideration will have to wait to be treated on a first come first serve basis. In this study, we investigate the effect of re-triage on patients waiting time and on the ED service by means of agent-based modelling and simulation. The simulation is based on historical records of patients presenting to the ED of Hospital USM in the year 2011. The result of the simulation shows that the implementation of re-triage in the conventional three-level triage system can significantly Reduce the waiting time of patients with deteriorating clinical conditions, with slight increase in the demand for ED service due to the re-triage activity.