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The purpose of this paper is to explore the configuration of factors affecting the accuracy of triage decision-making. The contribution of the work is twofold: first, it develops a protocol for applying a fuzzy-set qualitative comparative analysis (fsQCA) in the context of triage decision-making, and second, it studies, through two pilot cases, the interplay between individual and organizational factors in determining the emergence of errors in different decisional situations.

The methodology adopted in this paper is the qualitative comparative analysis (QCA). The fuzzy-set variant of QCA (fsQCA) is implemented. The data set has been collected during field research carried out in the Emergency Departments (EDs) of two Italian public hospitals.

The results of this study show that the interplay between individual and contextual/organizational factors determines the emergence of errors in triage assessment. Furthermore, there are some regularities in the patterns discovered in each of the investigated organizational contexts. These findings suggest that we should avoid isolating individual factors from the context in which nurses make their decisions.

Previous research on triage has mainly explored the impact of homogeneous groups of factors on the accuracy of the triage process, without considering the complexity of the phenomenon under investigation. This study outlines the need to consider the not-linear relationships among different factors in the study of triage’s decision-making. The definition and implementation of a protocol to apply fsQCA to the triage process in EDs further contributes to the originality of the research.

Simple Triage and Rapid Treatment (START) is a unique triage system used by prehospital providers during disasters to quickly categorize and prioritize patient care according to severity. This study aims at evaluating knowledge about the START triage system among field emergency medical service (EMS) personnel working at the Saudi Red Crescent Authority (SRCA) in the stations of the city of Riyadh.

This is a cross-sectional study that examined data collected from August 2019 to January 2020. The statistical population is from all field EMS personnel working in the SRCA located in Riyadh, Saudi Arabia. Using simple random sampling, 239 field EMS personnel were assessed, and 235 completed the study (98.3% response rate). Data were collected electronically using demographics and 15 multiple choice emergency scenarios based on the START protocol.

The mean correct score is 8.21 ± 3.36 out of 15 questions of triage knowledge (score of 0–15 points), indicating that those respondents have moderate knowledge levels on the START triage tool. Physicians and paramedics have higher mean scores (10.13 ± 3.42 and 9.07 ± 3.22, respectively), which are significantly higher than emergency medical technicians and nurses (7.25 ± 3.15 and 5.63 ± 2.72, respectively; p < 0.05). The providers who attended the training course had higher mean scores (p < 0.05).

Based on the results of the study, field EMS personnel did not reflect full knowledge of START triage tool. An interdisciplinary approach that adopts reinforcement education and periodical training courses is highly recommended to improve the respondents' performance and productivity. Moreover, there was a noticeable correlation between performance of respondents on the one hand and their education levels and prior training on the other hand.

This paper aims to suggest ways to complete the enhancement of the policy responses to systemic banking crises that followed the Great Financial Crisis.

An integrated macrofinancial analytical framework was designed to overcome the segregation between macro work, based on national accounting concepts, and prudential oversight of financial institutions, based on business accounting and concepts.

The design and implementation of the integrated macrofinancial framework are within reach, supported by extensive ongoing research work around the world, and correspond to rising expectations by the international community. It will lead to improvements in the way systemic banking crises are managed. Even more importantly, it offers a promising avenue to make further progress in the prevention of future crises.

The main limitations are the need to overcome the well-known constraints of national accounting, and to overcome the enduring silo separating macro-economists from financial sector experts. The implications are the need for extensive additional interaction between these two groups of experts.

The practical, operational implications are extensive, and could yield a major impact on the global financial stability work agenda. The design of policy responses to systemic banking crises could be profoundly affected, in particular with regard to the target of these responses (corporates vs banks in particular).

The direct and indirect costs of systemic banking crises could be reduced, with widespread benefits for society at large.

This is a fully original new proposed approach with extensive operational value for practitioners.

Prisoners’ oral health is an often overseen, yet important aspect of the general health of prisoners. To develop effective measures to improve the situation, it is important to get an overview of existing research. The purpose of this study is to examine and analyse existing research on oral health of prisoners and provide a thorough understanding of prisoners’ oral health and related factors.

Due to relatively few scientific papers on prisoners’ oral health, an integrative review was chosen. Integrative reviews allow for the inclusion of diverse methodologies. A literature search was conducted, followed by an assessment of the quality of the studies by using the Mixed Methods Appraisal Tool. Thematic analysis was used to analyse the studies.

The few studies addressing European prisoners’ oral health in the last 21 years differ in design and methodology. The results from this review indicate that prisoners’ oral health is a complex phenomenon and should be understood from both individual and organisational perspectives. More research is needed to bridge the gap in the literature on prisoners’ oral health.

To the best of the authors’ knowledge, this is the first literature review on European prisoners’ oral health.

The purpose of this paper is to investigate the influence of organizational factors on individual decision-making under conditions of uncertainty and time pressure. A method to assess the impact of individual and organizational factors on individual decisions is proposed and experimented in the context of triage decision-making process.

The adopted methodology is based on the bias-variance decomposition formula. The method, usually applied to assess the predictive accuracy of heuristics, has been adjusted to discriminate between the impact of organizational and individual factors affecting heuristic processes. To test the methodology, 25 clinical scenarios have been designed and submitted, through simulations, to the triage nurses of two Spanish hospitals.

Nurses’ decisions are affected by organizational factors in certain task conditions, such as situations characterized by complete and coherent information. When relevant information is lacking and available information is not coherent, decision-makers base their assessments on their personal experience and gut feeling.

Discriminating between the influence of organizational factors and individual ones is the starting point for a more in-depth understanding of how organization can guide the decision process. Using simulations of clinical scenarios in field research does not allow for capturing the influence of some contextual factors, such as the nurses’ stress levels, on individual decisions. This issue will be addressed in further research.

Bias and variance are useful measurements for detecting process improvement actions. A bias prevalence requires a re-design of organizational settings, whereas training would be preferred when variance prevails.

The main contribution of this work concerns the novel interpretation of bias and variance concepts to assess organizational factors’ influence on heuristic decision-making processes, taking into account the level of complexity of decision-related tasks.

This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.

This research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.

Patient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.

This study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.

Orthopaedics, rheumatology, pain management, specialist radiology and therapy services were brought under one umbrella to form Northwest Surrey integrated musculoskeletal (IMSK) services and introduced advance clinical practice, a multi-disciplinary team triage with a formalised straight to test (STT) process defined in 2018. Historically, prior to these services' integration, there were a primary and second care triage systems within individual specialities. The aim of this service evaluation is to assess the impact of a single IMSK multidisciplinary triage (MDT) system and the efficacy of STT from triage, which allows patients to be sent for diagnostics based on the cluster of symptoms and past medical history in order to achieve early identification of serious pathologies. This is a complex adaptive system with pathways spanning into the core areas of orthopaedics, rheumatology, therapies, pain management services, radiology and some less frequent specialities such as neurology, oncology, vascular and gynaecology. One of the objectives of this study was to identify how many referrals were triaged to consultants, Advance practice and therapies. In addition, the authors wanted to highlight the proportion of referrals that were sent straight to test from triage and the percentage of these that had sinister pathology identified. This information would then be compared against existing red flag literature to identify common themes. This study aims to discuss the aforementioned objectives.

Data were extracted retrospectively from a hospital database from January to December 2019 for all the adult musculoskeletal service referrals. The data collected were analysed on a Microsoft Excel sheet with information including date of triage, hospital number, ordering clinician, body part, type of diagnostic, indications for scanning, outcome for STT, serious pathology findings (named code 5 within our trust) and outcome of appointment.

A total of 47,039 referrals were received into the IMSK service. Of these referrals 19,967 were directly referred to therapies, with 27,072 referrals received into the IMSK service MDT process. Within triage, 718 patients were directed to STT to rule out serious pathology. A total of 28 patients (3.9%) had sinister pathology identified on their investigation. A total of 46% of patients were discharged from their first consultation following STT. Overall, 50% of the total number of referrals into the IMSK service was seen by advanced practitioners with 16% of patients directed to consultants with pre-consultation diagnostic work up.

This service evaluation highlights that STT allows early access to diagnostics, resulting in quicker access to identification of sinister pathology. A one stop MDT system has been shown to be effective in guiding the referral to the right place with increased referrals into allied health advance practice clinics and access to therapies directly. It has resulted in a reduction of unwarranted referrals to consultant care, duplication of investigations and identified patients on multiple pathways.

The purpose of this paper is to demonstrate a “maintenance pathway” for ensuring a low false negative rate in closing investigations unlikely to lead to a clearance (detection).

A randomised controlled experiment testing solvability factors for non-domestic cases of minor violence.

A random selection of 788 cases, of which 428 would have been screened out, were sent forward for full investigation. The number of cases actually detected was 22. A total of 19 of these were from the 360 recommended for allocation. This represents an improvement of accuracy over the original tests of the model three years earlier.

This study shows how the safety of an investigative triage tool can be checked on a continuous basis for accuracy in predicting the cases unlikely to be solved if referred for full investigations.

This safety check pathway means that many more cases can be closed after preliminary investigations, thus saving substantial time for working on cases more likely to yield a detection if sufficient time is put into the cases.

More offenders may be caught and brought to justice by using triage with a safety backstop for accurate forecasting.

This is the first published study of a maintenance pathway based on a random selection of cases that would otherwise not have been investigated. If widely applied, it could yield far greater time for police to pursue high-harm, serious violence.

South Wales Police Mental Health (MH) Triage service was initiated to meet the Welsh Government MH priority of early intervention to prevent MH crisis. Community Psychiatric Nurses, based in the control-room, provide advice to police and control room staff on the management of MH-related incidents. The purpose of this paper is to evaluate the first 12 months of operation (January-December 2019).

Service evaluation of the first 12 months of operation (January–December 2019). Data were analysed in relation to: MH incidents; repeat callers; Section (S)136 use/assessment outcomes. Police, health staff and triage service users were interviewed and surveyed to capture their opinions of the service.

Policing areas with high engagement in triage saw reductions in S136 use and estimated opportunity costs saving. Triage was considered a valuable service that promoted cross agency collaborations. De-escalation in cases of mental distress was considered a strength. Access to follow-on services was identified as a challenge.

Triage enables a multi-agency response in the management of MH-related incidents. Improving trust between services, with skilled health professionals supporting police decision-making in real time.

There is a gap in the research on the impact of police-related MH triage models beyond the use of S136. This project evaluated the quality of the service, its design and the relationship between health, police and partner agencies during the triage process. Multi-agency assessment of follow-up is needed to measure the long-term impact on services and users.

Building on the findings of a British Academy-funded project on the development of digital forensics (DF) in England and Wales, the purpose of this paper is to explore how triage, a process that helps prioritise digital devices for in-depth forensic analysis, is experienced by DF examiners and police officers in four English police forces. It is argued that while as a strategy triage can address the increasing demand in the examination of digital exhibits, careful consideration needs to be paid to the ways in which its set-up, undertaking and outcomes impact on the ability of law enforcement agencies to solve cases.

The methodological approach adopted here builds on the ethnographic turn in criminology. The analysis draws on 120 h of ethnographic observations and 43 semi-structured interviews. Observational data of the working DF environment at each location and a systematic evaluation of internal documents, organisational settings and police priorities helped refine emergent analysis threads, which were analytically compared between sites and against the testimonies of members of different occupational groups to identify similarities and differences between accounts.

The findings emphasise the challenges in the triage of digital exhibits as they are encountered in everyday practice. The discussion focusses on the tensions between the delivery of timely and accurate investigation results and current gaps in the infrastructural arrangements. It also emphasises the need to provide police officers with a baseline understanding of the role of DF and the importance of clearly defined strategies in the examination of digital devices.

This paper aims to bridge policy and practice through an analysis of the ways in which DF practitioners and police officers in four English constabularies reflect on the uses of triage in DF to address backlogs and investigative demands. Highlighting the importance of digital awareness beyond the technical remit of DF units, it offers new insights into the ways in which police forces seek to improve the evidential trail with limited resources.