Impact of using the ASIGNA computer program in a hospital emergency department

Objective: To determine whether the ASIGNA program for assigning patients to nursephysician

teams expedites time until the initial evaluation of a patient by an emergency

physician in the Hospital General Universitario de Elda, Spain.

Methods: Nonrandomized study of the effect of using the ASIGNA program from

February 2012 to February 2013. The main outcomes were times in minutes until triage

and until the initial evaluation by an emergency physician, and the qualitative

assessment of compliance or not with times considered reasonable for each color-coded

priority category in the Manchester triage system. Secondary variables recorded were

sex, age, triage color code, and number of patients waiting. Multivariable linear

regression analysis was used to study time between triage and physician evaluation in

minutes; logistic regression analysis was used to study the associations with reasonable

time according to the Manchester triage system. Indicators of clinical relevance were

calculated with 95% confidence intervals (CI).

Results: The rates of correctly performed triage increased from 68.2% to 90.6% with use

of the ASIGNA program (P<.001). Time from triage to physician evaluation decreased from 63.6 minutes to 25.2 minutes (P<.001), and the number of patients waiting decreased from 23.8 to 18.0 (P<.001). Analysis of indicators of clinical relevance showed improvements in both absolute risk (reduction of 0.22; 95% CI. 0.19-0.26; P<.001) and relative risk (reduction of 0.70; 95% CI. 0.64-0.76). The number of waiting patients fell by 5 (95% CI. 4-6) The ASIGNA program made it possible to attend 4-fold more patients within an amount of time considered reasonable. Conclusions: The use of the ASIGNA program leads to statistically significant and clinically relevant reductions in time from triage to physician evaluation.