Manchester Triage System
Triage: 'The assignment of degrees of urgency to decide the order of treatment.' (Oxford English Dictionary)
The Manchester Triage System is a clinical risk management tool used by clinicians worldwide to enable them to safely manage patient flow when clinical need far exceeds capacity.
The Manchester Triage Group was set up in November 1994 by a group of Emergency Nurses and Physicians from each of the Manchester Emergency Departments, including general EDs, two paediatric EDs and one ophthalmic ED. Their aim was to establish a consensus among senior Emergency Physicians and Emergency Nurses regarding triage standards, in order to ensure consistency and safe patient triage.
It soon became apparent that the aims of the group could be set out under five headings;
- Development of common nomenclature
- Development of common definitions
- Development of a robust triage methodology
- Development of a standardised training package
- Development of an audit guide for triage
The MTS is now an integrated series of tools used in the following domains (click on the titles to learn more about each of them):
- Emergency Triage: Emergency departments
- Telephone Triage and Advice: Urgent care desks
- Pathfinder: Paramedic ambulances
- Nursing and Residential Triage: Nursing and residential homes
- SAFE pathways: Community-based HCPs
The 5 triage tools all share:
- A reductive methodology identifying life threatening illnesses and injuries first
- A clinical risk management tool used Worldwide to safely manage patient flow when clinical demand exceeds capacity
- A common set of discriminators defined in a discriminator dictionary
- A shared language and common understanding
- Underpinning training packages and e-learning modules for practitioners
- A method of streaming for local implementation
The Manchester Triage System is now the International Gold standard for Emergency Triage, used worldwide to triage millions of patients per year.
The key features of the Manchester Triage system are that it is reductive. It starts from the premise that the patient is presenting with a life threatening condition and this must be ruled out in all cases; in this way, no serious patient conditions are missed.
The MTS is presentation, not diagnosis based; charts are based on what the patient says is happening, not what might be the cause of this.
It is a professional, expert system and the most, rather than the least experienced personnel in the department should be using it.
The triage priority is a clinical indicator and is absolute. The management of particular patient streams depends on the department priorities and facilities available; management of patients should never be confused with a patients clinical priority.
It must also be recognised that decisions made regarding patient outcome is a clinical judgement made by the clinician; and that as long as the MTS is used accurately the system will be safe.
Whichever iteration of MTS is used, it must be acknowledged that in order for the system to be used safely, clinicians utilising the MTS must have undergone approved training from a registered MTS instructor.