Radboudumc and partners Gaming helps GP and triage operator quickly decide which help is necessary

14 March 2023

Fast, accurate, and safe decisions by general practitioners and in the emergency room ensure that patients receive the right (emergency) care as quickly as possible. This allows for a more efficient throughput throughout the entire care chain. As of March 15, general practitioners and triage specialists (and those interested) can use Triagegame.nl (in Dutch) to improve this assessment and decision process (triage). The game will also be included in the national general practitioners training program. Triagegame.nl is an initiative of Boukje van Dijk of Radboudumc, has was developed in collaboration with general practitioners and triage specialists.

Astrid Scholl, program manager for multidisciplinary and acute care at InEen: "The triage process is essential within acute general practitioner (GP) care to prevent unnecessary reliance on acute care. In doing so, triagers ensure safe regulation of patient flow. InEen therefore embraces Radboudumc's initiative in which GPs and triagists can playfully understand the triage process even better."

Limited emergency capacity

Our GP care is accessible 24/7, but both during the day and evening/night/weekend hours, we are dealing with limited capacity. To properly and safely organize the limited capacity of emergency care, triage is applied when a patient is brought in. GPs and triage specialists are jointly responsible for a smooth triage process. The purpose of triage is to get the best possible estimation of the patient's state of health with a limited number of questions, using the Dutch Triage Standard.

Responsible, but hardly trained

The initiator of the game is general practitioner Boukje van Dijk. In addition to her job as a general practitioner, she is curriculum coordinator of the continuing education program for general practitioners at Radboudumc. Boukje is often on duty at the GP clinic and is, among other things, ultimately responsible for the work of the triagists.

"As a general practitioner you are trained to make the best possible diagnosis. Determining the urgency of a case is a very different ballgame, for which you are hardly trained as a general practitioner but are ultimately responsible. Moreover, a smooth triage process is very important for the functioning of the entire emergency care chain. This requires fast and good triage without compromising patient safety. Sometimes patients call with questions that can really wait until the next day without risk, so that they can be treated at their own GP's, for example in case of complaints of excessive earwax or unchanged chronic complaints, such as persistent lower back pain."

Together with general practitioners, triagists, and emergency care education specialist Schola Medica, she developed the Triage Game with funding from the HDS Fund.

The game

The Triagegame.nl is the first web-based and open source training game within emergency care. It is intended for every general practitioner and triage operator who wants to understand or improve the triage process. The game is based on the Dutch Triage Standard (NTS). In the game you will learn, in a playful and realistic setting, how triage works, which criteria are used, and what the potential pitfalls are.

Getting started

In the game, you get to work as a triage operator and are taken through the triage operator's thinking and decision-making process. You get a call from a patient with a request for help, and you will ask a number of questions (triage) to quickly determine with what urgency and by which healthcare provider the patient needs to be seen (or not). At the end of the call you get to see the "score"; did you ask the right questions and take the right follow-up actions?

The entire game takes about 60 minutes and can be played over and over again. You can play the game on 3 levels with four patients on each level. Pausing in-between is no problem either, the game "remembers" where you left off on the same device.

The Dutch Triage Standard Foundation provides updates for the game so that it remains a good practice tool.

Video (in Dutch):

Cooperation partners

The initiative and expertise come from general practitioners affiliated with the Department of Primary Care of Radboudumc. Students from HAN University of Applied Sciences worked on a prototype, which secured funding from the HDS Fund. IJsfontein developed the game and Schola Medica, as the owner, is responsible for management and maintenance. The Dutch Triage Standard Foundation will continue to provide the game with updates.

Through Schola Medica and GP training in the Netherlands, the Triage Game will have a permanent place in education. The primary care branch association “Ineen” embraces the game and offers it to all members.

Original source: https://www.radboudumc.nl/nieuws/2023/gaming-helpt-huisarts-en-triagist-snel-te-beslissen-welke-hulp-nodig-is

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