How to implement a unique triage system in the emergency departments of Latium, Italy

Triage is an efficient system that emergency departments (EDs) use to sort out presenting patients on the basis of the speed with which they need treatment. Because triage is not used consistently in the EDs of Latium, a region in central Italy, the regional Public Health Agency (PHA) planned and implemented a regional model of triage in all EDs. This manuscript describe the regional implementation strategy. The PHA activated the "Regional Triage Program--RTP" including: development and testing of a "triage section" in the computerized EDs clinical chart; production of an operational handbook for the RTP for triage health professionals (HPs); implementation of an continuum educational program on the "RTP" in all EDs of Latium. The computerized triage section was tested and implemented in all EDs in the region. The handbook for triage HPs was produced. The educational program, has been ongoing since 2008 in all regional EDs. Selected HPs, identified as "facilitators", were trained on how to implement the RTP. They will organize, in their own EDs, small groups of nurses to conduct on-site training of the RTP. The RTP was received with enthusiasm by most HPs, however its introduction into current practice could be hampered by organizational/structural problems and conflicts between nurses and doctors. Next actions of the regional program will be to overcome the possible above mentioned troubles.