Triage a patient and route them to a department

Triage is where a patient’s vital signs and early assessment are recorded, and where they are routed to the department that will see them. A department’s triage queue is worked one department (and, where it has them, one sub-unit) at a time, and a saved triage is what puts a patient into that department’s consultation queue.

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Before you start

Triage has no care-area switch — it is always in the sidebar on the Enterprise plan, because every hospital sees patients. Your departments and sub-units must be set up first, or there is nowhere to route anyone; see Departments.

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Find a department

Triage List opens on Select a Department — “Choose the department you’d like to access.” Each department card shows how much is waiting: N emergency/emergencies, N waiting and N open, so you can see where the queue has built up before you open it. Choosing a department with more than one sub-unit asks for the sub-unit next; with only one you go straight through. A hospital with no departments set up sees No Departments Found and a Set Up Departments button instead.

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What you’re looking at

A department’s queue is a rolling window — 48 hours by default, wider if an owner or manager has changed it under Facility settings — with a Search patients box in the header, next to Board view. A Waiting section lists everyone this queue is waiting to triage — this is the only way to start a triage; the Search patients box narrows which cards and rows show, it does not open a separate way in. At a paid hospital that means patients with a valid, unused payment for this department, each card showing the consultation, how many visits the payment covers (One visit, Unlimited, or Up to N) and how long it has left (9 days left, Expires today). Under Free Clinic Mode it instead means patients checked in today, or booked with an appointment today, who have not yet been triaged in this department — a checked-in patient shows the time they checked in (Checked in 09:12), and a patient who is only booked (not yet checked in) shows the appointment’s time instead (Appointment 10:30); a patient who is both booked and checked in shows just the checked-in card. There is no payment to expire, so no countdown. Either way, each card carries a Start triage button. A hospital with nobody waiting sees “No one is checked in or booked for today and waiting for triage” (free clinics) or simply no Waiting section (paid clinics with nobody paid and untriaged). A card that was put back on the list with Requeue patient (see below) instead of a fresh payment shows Requeued by [name] at [time], with its own Cancel requeue action. Below that, the triage table itself: An empty queue reads “No triaged patients in this window,” or “No patients match {what you typed}.” while you are searching. Older records than the window live on Triage history.

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Start or open a triage

If you are allowed to set acuity and none is assigned, Mark triaged (and Send to consultation) first asks No acuity has been assigned to this patient. Mark triaged anyway? — confirm to continue, or cancel and set the acuity first. Mark triaged always shows, even when it cannot be used yet: before the first save it is greyed out with Save the triage first, and once a record has moved on (in consultation, admitted, discharged, or left without being seen) the button is replaced by that status in words — e.g. “Triaged — waiting for the doctor” — so the chart never simply drops a button with nothing said about why.

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The triage chart

Opening a queue row — a Waiting card or an already-triaged row — replaces the queue with the chart, in tabs:

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Nurse orders

The Orders tab has Medications, Labs, Imaging and Services sub-tabs, with a count on each, exactly as on the consultation’s Orders tab. The sub-tab you are on stays in the address, so a reload or a shared link opens it.

• Nurse orders work only when the patient’s chief-complaint category is one your clinic allows under Settings → Facility → Triage → Nurse orders. If it is not, every sub-tab is replaced by a note saying so.
• Each order is saved as soon as you add it. Orders go onto the patient’s consultation: the one already open for this visit, or — if there is none yet — a new one with no doctor assigned, which the doctor’s queue shows as “Nurse orders — awaiting doctor”. A consultation the doctor has already signed does not take new orders; the tab says so.
• Medications go to the pharmacy list like any prescription and carry your name as the person who ordered them. There is no separate doctor sign-off step for a medication ordered from triage.
• Medications, labs and imaging each follow the role choices under Settings → Facility → Clinical access. If your role may not do one, its sub-tab stays visible with the reason and you cannot add to it. Services have no role setting.
• An order you have placed can be withdrawn only once the doctor opens the consultation.

If the patient is already on a ward, their card on the Waiting list carries an Admitted · ward chip with the date the stay began, so you know before you open the chart. Opening it, a banner at the top says so — the ward and bed, the date the stay began, and Open ward chart. You can still triage an admitted patient; the banner is there so you know. If the admission looks old, close it from Discharges. What you record here is not copied anywhere. The doctor sees every field of the Notes tab on the consultation under From triage (directly below Vitals at a glance) and in the Triage notes sub-tab of the consultation’s Vitals tab, and the ward sees it on the admission’s SnapShot and in the Triage notes sub-tab of Care History. Placing a nurse order or saving a note does not admit anyone — a patient is admitted only when someone chooses Admit and picks a bed. A brand-new triage opens on Vitals — the first thing taken at the door. An existing one opens on Overview.

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Assessments — GCS, Blantyre, pain, qSOFA, SIRS, AVPU, ASA and more

The Assessments tab offers every instrument that applies to the patient’s age: Glasgow Coma Scale (GCS), Blantyre Coma Scale (the paediatric coma scale for low-resource settings), the Numeric Rating Scale, Wong-Baker FACES and FLACC pain scales, AVPU, qSOFA, SIRS Criteria and the ASA Physical Status Classification. Pick one, answer its questions, and the score and band update live as you go — scoring is checked again on the server, so a manipulated or stale answer set is refused rather than silently accepted. Every scored attempt is kept, newest first; re-scoring a patient adds a new entry rather than overwriting the last one, so a Glasgow score that drops from 14 to 9 stays on the record. SATS, TEWS and Brighton PEWS are shown as “Pending clinical review” and cannot be selected until a clinician has signed off the published tables they are built from. Until then, a paediatric early-warning score falls back to flagging individual vital signs outside their normal range rather than producing a composite score from an unreviewed instrument.

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Growth percentiles for children

For a patient young enough for it, the Vitals tab also records head circumference and shows a weight-for-age and a height-for-age percentile beside the reading, worked out against WHO growth reference data.

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Acuity and reassessment

Your hospital’s acuity system — Emergency Severity Index (ESI), levels 1 (Resuscitation) to 5 (Non-urgent), or South African Triage Scale (SATS), once reviewed — is set under Facility settings. Each level carries its own reassessment interval (ESI 1 is continuous care with no timer; the others default to 15, 30, 60 and 120 minutes); the queue’s Wait / Reassess column counts down and turns amber, then red and Overdue, if nobody records a reassessment in time.

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Quick actions from the queue

Select a row’s ⋯ menu for actions that do not need the full chart: Most of these confirm instantly with a toast carrying an Undo button, active for six seconds — undoing is itself a recorded change, not a deletion of the mistake. Left without being seen and Admit ask you to confirm first, since neither has an undo. An action you may not perform is shown, not hidden, greyed out with the reason on hover — never a puzzle of a missing button.

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Track board

Select Board view beside the department name (List view returns to the table) to see the queue laid out as columns instead of rows — one column per named location you have set up for this department under Facility settings, plus a final Unplaced column, each card showing the patient’s acuity, wait and reassessment chip just as the list does. Drag a card to another column, or use its own Move to… menu, to move that patient. Both go through the same write as the row menu’s own Move to…, so the list and the board can never disagree about where somebody is. A column with nobody in it reads No patients here. Moving a patient needs the Record triage permission the same as everywhere else — without it you can see the board but not move anyone on it.

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Emergency triage

The department queue’s Emergency button (and a row’s Mark emergency) open a short Emergency triage sheet: pick or confirm the patient, a grade, the chief complaint and any vitals you have, then select Record emergency. It saves in one step and pins the patient first in the department’s consultation queue with a red Emergency flag — the payment gate still applies at a paid hospital, and a patient with no valid payment is refused with a link straight to Billing so the desk can clear it without losing what was typed.

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Requeue a returning patient

A consultation rate can cover more than one visit — set under Departments as Unlimited within validity or Up to N visits. A patient on such a rate who needs to be seen again does not need a new payment: select Requeue patient on the department’s queue (or from the front desk’s check-in board) to put them back on the Waiting list. A requeue never takes a visit off the payment and never creates a triage record by itself — the nurse still opens the chart and triages the patient as usual; the visit is only counted once the doctor opens the consultation. Requeuing a patient who is already on that department’s waitlist is refused with the date their consultation is valid until and the visits they have left — cancel the first requeue if it was a mistake. Being in the triage queue never stops a requeue.

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Shift handover

A Handover button on the department queue opens the department’s shift handover: a running thread of notes tagged Staffing, Equipment, Surge or Safety, who is on this shift and the next (from your rota, where one exists), and — for the incoming shift — an Acknowledge handover from button naming the previous shift, once they have read it. It is a quiet indicator, never a gate: an unacknowledged handover shows a badge but blocks nothing. Each patient still in the queue can also carry its own handoff, written as Situation / Background / Assessment / Recommendation or as free text, from the chart’s own Handoff tab or from the panel. Add handoff opens a side panel; Update handoff opens the same panel already filled in with the patient’s latest handoff, so you change only what is out of date — saving adds a new entry. The latest handoff’s text is shown under the patient on the panel. The chart’s Handoff tab lists every handoff for the patient, including ones from an earlier visit, and shows an error with Try again if they cannot be loaded. A patient with no handoff written this shift is flagged so nothing is handed over silently. Select Print on the handover panel for a paper copy of the same information. You can correct a note or a handoff you wrote while its shift is current, and for one hour after it ends: select Edit under your entry, change it and select Save correction. It then shows Edited with the time, and anyone can open what it said before — the original is kept. Nobody else can change your entry. A nurse who already acknowledged the handover sees Edited after you acknowledged on an entry that changed afterwards. The panel opens on a Current shift tab. Select Previous shifts to page back through this department’s history — each row names the shift and when it started, how many notes and handoffs it carries, who wrote them, and whether the incoming shift acknowledged it; select a row to read its notes and handoffs. History stays scoped to the exact department (and sub-unit, if you opened one) you are viewing — it never mixes in another department’s notes.

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Who can do this

Record triage was switched on for everyone already governed by permissions when it shipped, since recording triage was never previously restricted — it behaves like every other permission from here on. Set triage acuity is new capability and starts off for everyone, badged New, until an owner or manager saves it on. Two behaviours worth knowing. Permission enforcement is opt-in per person — someone never saved in the Permissions sheet is unrestricted. And hiding a module from a role in Role Navigation tidies the sidebar; it is not a security boundary. A denied action is recorded in the audit log; an allowed one is not.

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Check it worked

• The new record appears at the top of its department’s queue with today’s time against it.
• Open Consultation for that department — the patient is in the queue, with their acuity and chief complaint shown against the row.
• Reopen the triage from the queue: everything you entered — vitals, assessments, notes — reads back exactly as saved.

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Common issues

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FAQ