[2025] Transitioning from clinical-only to resource-aware triage: the impact on Emergency Department performance

Recently, the Italian emergency department (ED) triage system shifted from clinical-only to resource-aware prioritization. This study examines its impact on ED performance across a four-facility hospital network. Relying on a two-year dataset covering one year before and one year after the change, we employ interrupted time series analysis to estimate effects in daily average waiting times and on-time performance, adjusting for ED and patient characteristics. Results show an initial drop in performance, followed by a mid-to-long-term recovery. Notably, the impact varies across facilities, with greater improvements seen in those that initially had a lower level of efficiency.