<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0001-6002</journal-id>
<journal-title><![CDATA[Acta Médica Costarricense]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. costarric]]></abbrev-journal-title>
<issn>0001-6002</issn>
<publisher>
<publisher-name><![CDATA[Colegio de Médicos y Cirujanos de Costa Rica]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0001-60022016000300110</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Resultados cuantitativos de la implementación de la Escala Canadiense de Triaje y Severidad en el servicio de emergencias de un hospital nacional]]></article-title>
<article-title xml:lang="en"><![CDATA[Quantitative outcome of the implementation of the Canadian Triage and Severity Scale in the Emergency Department of a national hospital]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Schmitz]]></surname>
<given-names><![CDATA[Gerald]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,CCSS Servicio de Emergencias del Hospital &#8220;Dr. Rafael Ángel Calderón Guardia&#8221; ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2016</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2016</year>
</pub-date>
<volume>58</volume>
<numero>3</numero>
<fpage>110</fpage>
<lpage>114</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_arttext&amp;pid=S0001-60022016000300110&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_abstract&amp;pid=S0001-60022016000300110&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.sa.cr/scielo.php?script=sci_pdf&amp;pid=S0001-60022016000300110&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Justificación: La clasificación Canadiense de Triaje y Severidad está siendo utilizada en un número creciente de servicios de emergencias; sin embargo, la bibliografía médica ha evidenciado la problemática de su aplicación. Este estudio pretende analizar el resultado de implementar este sistema de clasificación en el Servicio de Emergencias del Hospital Calderón Guardia, con respecto a la mortalidad y otras variables.  Métodos: Se realizó un análisis comparativo de variables como fallecimientos, cuantía de consultas diarias, estancia promedio y hora paciente, durante un lapso de 14 semanas, antes y después de implementado el sistema de clasificación.  Resultados: Se encontró cambios significativos con tendencia a la disminución en la consulta diaria y en los egresos rápidos en menos de 1 hora, mientras que hubo cambios significativos con tendencia al crecimiento en la estancia promedio del paciente en el Servicio, y en la mortalidad general. No se halló cambios significativos con respecto a horas paciente diarios, ni en los fallecimientos durante las primeras 2 horas.  Conclusiones: El estudio muestra el impacto de implementar un sistema de clasificación en un servicio de emergencias, asociándose a fenómenos preocupantes como el aumento de la mortalidad y el tiempo de estancia. Además, sugiere la necesidad de un abordaje más complejo de la gestión de los servicios de emergencias.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Background: The Canadian Triage and Severity Scale is being used in a growing number of Emergency Departments, however the medical literature shows several problems in its application. This study pretends to analyze the outcome of the implementation of this classification in the Emergency Department of the Hospital &#8220;Dr. Rafael Ángel Calderón Guardia&#8221; regarding mortality and other variables.  Methods: A comparative analysis was done on variables like mortality, daily consults, average stay and daily patient hours during a 14 week period before and after the implementation of the classification.  Results: Significant negative trend was found in the case of daily consults and fast discharges of less than one hour, while significant positive trend was found in the average length of patient stay in the department and general mortality. No significant changes were present in the case of daily patient hours and deaths during the first 2 hours.  Conclusion: The study shows the impact of the implementation of a classification system in an emergency department, associated with worrisome results like the elevation of mortality and average length of stay. It also suggests the need of a more complex triage approach in the management of an emergency department.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Servicio de Emergencias en hospital]]></kwd>
<kwd lng="es"><![CDATA[triaje]]></kwd>
<kwd lng="es"><![CDATA[evaluación de resultados]]></kwd>
<kwd lng="en"><![CDATA[Emergency Service]]></kwd>
<kwd lng="en"><![CDATA[Hospital]]></kwd>
<kwd lng="en"><![CDATA[Triage]]></kwd>
<kwd lng="en"><![CDATA[Outcome Assessment]]></kwd>
<kwd lng="en"><![CDATA[Health Care]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Farrohknia]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Castrén]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Ehrenberg]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Emergency Department Triage Scales and Their Components: A Systematic Review of the Scientific Evidence]]></article-title>
<source><![CDATA[Scand J Trauma Resusc Emerg Med]]></source>
<year>2011</year>
<volume>19</volume>
<numero>42</numero>
<issue>42</issue>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dallaire]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Poitras]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Aubin]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Lavoie]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Moore]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Emergency department triage: do experienced nurses agree on triage score?]]></article-title>
<source><![CDATA[J Emerg Med]]></source>
<year>2012</year>
<volume>42</volume>
<page-range>736-40</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Betz]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Stempien]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Wilde]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bryce]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A comparison of a formal triage scoring system and a quick-look triage approach]]></article-title>
<source><![CDATA[Eur J Emerg Med]]></source>
<year>2015</year>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mirhagi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Heydari]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mazlom]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ebrahimi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The reliability of the Canadian Triage and Acuity Scale: Meta-analysis]]></article-title>
<source><![CDATA[N Am J Med Sci]]></source>
<year>2015</year>
<volume>7</volume>
<page-range>299-305</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chan]]></surname>
<given-names><![CDATA[TC]]></given-names>
</name>
<name>
<surname><![CDATA[James]]></surname>
<given-names><![CDATA[PK]]></given-names>
</name>
<name>
<surname><![CDATA[Kelly]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Guss]]></surname>
<given-names><![CDATA[DA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impact of Rapid Entry and Accelerated Care at Triage on Reducing Emergency Department Patient Wait Times, Lengths of Stay and Rate of Left Without Being Seen]]></article-title>
<source><![CDATA[Ann Emerg Med]]></source>
<year>2005</year>
<volume>46</volume>
<page-range>491-7</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Holroyd]]></surname>
<given-names><![CDATA[BR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impact of triage liaison physician on emergency department overcrowding and throughput: A randomized controlled trial]]></article-title>
<source><![CDATA[Acad Emerg Med]]></source>
<year>2007</year>
<volume>14</volume>
<page-range>702-8</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Weyrich]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Christ]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Celebi]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Riessen]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Triage systems in the emergency department]]></article-title>
<source><![CDATA[Med Klin Intensivmed Notfmed]]></source>
<year>2012</year>
<volume>107</volume>
<page-range>67-78</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Terris]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Leman]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[OÇonnor]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Wood]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Making an IMPACT on emergency department flow: improving patient processing by consultant at triage]]></article-title>
<source><![CDATA[Emerg Med J]]></source>
<year>2004</year>
<volume>21</volume>
<page-range>537-41</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="">
<collab>Analyst Soft Inc</collab>
<source><![CDATA[StatPlus:mac - programa de análisis estadístico]]></source>
<year>2009</year>
</nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Moore]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Harvard]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<source><![CDATA[Creating Public Value: Strategic Management in Government]]></source>
<year>1995</year>
<publisher-loc><![CDATA[EEUU ]]></publisher-loc>
<publisher-name><![CDATA[Harvard University Press]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ben-Yakov]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kapral]]></surname>
<given-names><![CDATA[MK]]></given-names>
</name>
<name>
<surname><![CDATA[Fang]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Li]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Vermeulen]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Schull]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The Association Between Emergency Department Crowding and the Disposition of Patients With Transient Ischemic Attack or Minor Stroke]]></article-title>
<source><![CDATA[Acad Emerg Med]]></source>
<year>2015</year>
<volume>22</volume>
<page-range>1145-54</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Geelhoed]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[deKlerk]]></surname>
<given-names><![CDATA[NH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Emergency department overcrowding, mortality and the 4-hour rule in Western Australia]]></article-title>
<source><![CDATA[MJA]]></source>
<year>2012</year>
<volume>196</volume>
<page-range>122-6</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Darrab]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Fan]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Fernandes]]></surname>
<given-names><![CDATA[CM]]></given-names>
</name>
<name>
<surname><![CDATA[Zimmerman]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Smith]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Worster]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[How does fast track affect quality of care in the emergency department?]]></article-title>
<source><![CDATA[Eur J Emerg med]]></source>
<year>2006</year>
<volume>13</volume>
<page-range>32-5</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bertalanffy]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<source><![CDATA[General System Theory: Foundations, Development, Application]]></source>
<year>1969</year>
<publisher-loc><![CDATA[New York, EEUU ]]></publisher-loc>
<publisher-name><![CDATA[George Braziller]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Miller]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Page]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Complex Adaptive Systems. An Introduction to Computational Models of Social Life]]></source>
<year>2007</year>
<publisher-loc><![CDATA[New Jersey, EEUU ]]></publisher-loc>
<publisher-name><![CDATA[Princeton University Press]]></publisher-name>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
