Hospitals begin sending back patients with minor ailments after ER triage
Since spring, hospitals have been allowed to send patients with milder health problems back home after an initial assessment in the emergency department. The first to start doing this was the North Estonia Medical Centre, which also issues an invoice for the work done in some cases of minor health concerns.
Although the North Estonia Medical Centre had long awaited the regulatory change that would allow a patient with a minor health issue to be sent from the emergency department after triage either home, to a pharmacy or to a family doctor, the use of the new option has been delayed due to IT problems.
"This has taken time, but since the 2nd of July we have launched it, and we are using it for one specific type of case. If a patient comes to the emergency department of the regional hospital with a tick bite, then the removal of the tick is done in triage," said PERH emergency department head Marit Märk.
Normally, after triage a person is sent on to a specialist nurse or a doctor, but in the case of a tick, the person is instead given a €50 invoice. In summer, nearly two hundred patients come to the emergency department with tick concerns. The list of issues that can be sent back will gradually be expanded.
"What is most likely to be expected in autumn are viral infections, mild runny noses and coughs, a couple of days of slight fever — these patients certainly do not need to be seen by either a specialist nurse or a doctor," Märk added.
Nor will patients with insect bites, mild rashes or abrasions that do not require stitching get past triage anymore. In the capital, patients sent away from the emergency department can turn to the Tallinn‑funded on‑call family doctor clinic, which cannot accept everyone who wishes to come.
"We have told the city of Tallinn that our capacity and opinion is that during the viral illness period the reception capacity should be somewhat larger, because during those periods — from December to the end of March — there were people who remained unserved or for whom no appointments were available," said Confido primary care clinic head Karita Košeleva.
According to the family doctor, Estonian people still believe strongly in the emergency department, and sometimes they drive tens of kilometres to Tallinn's emergency department instead of reading the health centre's website for advice on how to act in case of a simple health concern. The Tartu University Hospital will not act in the same way as the capital's hospital.
"Our principle is that the task of the triage nurse is to assess the patient's condition and the severity of the need for help — that is, how quickly the patient should receive assistance — and they should not be making such decisions," explained Tartu University Hospital's anaesthesiology and intensive care clinic head Veronika Reinhard.
According to Reinhard, triage nurses in simpler cases give recommendations to seek help elsewhere, but it is up to the patient to decide whether they stay for hours in the emergency department waiting for admission or go elsewhere.
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Editor: Mari Peegel, Argo Ideon
