Triage by Resource Allocation for INpatients [TRAIN®]: A Novel Disaster Triage Tool

Coordinating care with a common code

Lucile Packard Children’s Hospital Stanford, a tertiary care freestanding hospital for pregnant women, babies and children, created an innovative and novel disaster tool designed for the movement of hospitalized patients. It can rapidly assess patient transport needs for partial or vertical evacuation called TRAIN®. Whether the need is to evacuate the facility or to prepare for increased surge capacity, a triage method is required to quickly and accurately assess patients.

What is the TRAIN® Tool?

The TRAIN® tool that determines level of transport required for evacuation based on resource utilization. The tool aligns with local EMS protocols for transport type capabilities and expert opinion.

How and when the TRAIN® Tool is used

Advantages and uses of the TRAIN® Tool include the ability to quickly identify institutional transport needs for partial or vertical evacuation, to use standardized language for transport resource requests across a region, to highlight potential patients for rapid discharge when surge capacity is required, and to enable expedient resource requests from other agencies.

Implementation of the TRAIN® Tool

  • Manual implementation process – This is a simple tool that uses minimal time additional time during rounds at the time of a disaster.
  • Electronic implementation process – The electronic process is based on documentation and orders. The TRAIN® electronic algorithm was successfully integrated into 2 different electronic health record. The electronic process allows for creation of up-to-date reports, a decrease in time spent assessing patients, and improves relatability.

Links to TRAIN® Tool algorithms

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