J Adv Nurs. 2020;00:1–11. wileyonlinelibrary.com/journal/jan | 1 © 2020 John Wiley & Sons Ltd
1 | INTRODUCTION
Emergency Department (ED) triage is the process of quickly sorting
and prioritising arriving patients to initiate diagnostic procedures
and treatment (Fernandes et al., 2005). It is the first significant
interaction between patients and ED professionals. If patients’
urgency levels are underestimated (undertriage), they are at risk
for health deterioration while awaiting treatment. Conversely,
overestimates (overtriage) also have to be avoided: resources are
scarce and should only be used where needed. One approach to
Received: 14 May 2020
|
Revised: 28 September 2020
|
Accepted: 30 October 2020
DOI: 10.1111/jan.14675
ORIGINAL RESEARCH:
EMPIRICAL RESEARCH – QUALITATIVE
The challenge of interprofessional collaboration in emergency
department team triage – An interpretive description
Thomas Dreher-Hummel
1
| Christian H. Nickel
1
| Dunja Nicca
2
|
Florian F. Grossmann
3
1
Emergency Department, University
Hospital Basel, Basel, Switzerland
2
Department of Public Health, Institute of
Nursing Science, University of Basel, Basel,
Switzerland
3
Department of Medicine, Division of
Nursing, Emergency Department, University
Hospital Basel, Basel, Switzerland
Correspondence
Florian F. Grossmann, Department
of Medicine, Division of Nursing and
Emergency Department, University Hospital
Basel, Basel, Switzerland.
Email: florian.grossmann@usb.ch
Funding information
Professional language editing was funded by
the scientific fund of the University Hospital
Basel. Further funding was not necessary.
Abstract
Aims: To explore emergency nurses’ and physicians’ experience of collaboration and
collective decision-making when triaging older Emergency Department patients
within the interprofessional team triage system.
Design: Qualitative.
Methods: Semi-structured interviews were conducted with seven nurses and
five physicians. Transcripts were analysed via Interpretive Description between
September 2016–May 2017.
Results: ‘Negotiating collaboration’ was developed as the main theme. Three sub-
themes influenced the negotiation process: Participants described divergent opin-
ions on how an optimal triage system should work (‘preferences for triage systems’);
they had conflicting perceptions of each profession's role (‘role perceptions’); and
they expressed different coping strategies regarding ‘perceived time pressure’. The
compatibility of participants’ views on these sub-themes determined whether the
nurse and physician were able to successfully negotiate their collaboration. These
themes became more evident when the team triaged older ED patients.
Conclusion: Improving interprofessional team triage requires working with the in-
volved nurses’ and physicians’ values and beliefs. The strengths of both professions
need to be considered and a flexible approach to collaboration established according
to the patients’ situations.
Impact: Emergency Department leaders need to consider nurses’ and physicians’ val-
ues and beliefs to promote interprofessional collaboration in team triage.
KEYWORDS
emergency department, emergency medicine, emergency nursing, interpretive description,
interprofessional, nurses, older adults, physicians, teamwork, triage