Triage is a means of managing risk in the system and the duty roles are critical to this. Work on the triage list needs to be managed through the day in order to prioritise according to clinical need, available skill mix and the capacity on the day.
No system of access is risk-free and it can be argued that a total triage system is more likely to identify and manage patient need than a traditional pre-bookable system, where patient need is not identified early on and the system operates usually with fixed capacity and tries to squeeze in ‘on the day’ demand.
A mindset shift for teams moving to total triage is that the role of triage is simply to get patient need met with the minimum of handoff – this might be a face-to-face appointment or an AccuRx message. This is different to the ‘on-call’ doctor in a pre-bookable system where the role is more about firefighting and trying to limit overbooking in a system that is already working at capacity.