Development and Evaluation of an Outpatient Triage System in the Ear Nose and Throat Department, Mahasarakham Hospital

Abstract

Objective : To analyze the situation, develop, and evaluate an outpatient triage system for the Ear, Nose, and Throat (ENT) department at Mahasarakham Hospital.

Methods : A research and development study comprising three phases — situational analysis, development, and evaluation — was conducted between March–December2025. The sample consisted of 3 registered nurses and 370 patients. Research instruments included satisfaction questionnaires.Triage accuracy was evaluated as the percentage of Correct, Under, and Over Triage. Data were analyzed using descriptive statistics and pre–post development comparisons.

Results : Phase 1 revealed that triage practices lacked standardization and had a high rate of Under Triage. Phase 2 produced a concrete and clearly defined ENT-specific triage system that was practically implementable, named the E-N-T Model, comprising three core components: (1) an ENT-specific triage manual (ENT: E), (2) a triage recording form (Note form: N), and (3) a revised urgency classification system (Triage: T). Phase 3 found an overall triage accuracy of 96.49%; the white-code group achieved 100% accuracy, while the yellow-code group had an Under Triage rate of 28.57% and an Over Triage rate of 8.57%. The average waiting time for yellow-code patients was 31 minutes. Nurse satisfaction was rated high to very high, and patient satisfaction was very high (mean scores 4.55–4.85), particularly regarding confidence in the system and staff courtesy.

Conclusion : The development of a specialty-specific triage manual shows promise in improving triage efficiency and satisfaction among both patients and healthcare providers. Nevertheless, continuous staff development is recommended to reduce the Under Triage rate among yellow-code patients, and the service environment should be further improved.