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P-115 Traffic jam: RAG triage system to manage increase in referrals to community palliative care service
  1. Marie-Claire Rooney,
  2. Nicola Munnelly and
  3. Tracy Browning
  1. St Luke’s Hospice


Background During 2020 we saw a rise in referrals to our community palliative care service. Given the backdrop of the pandemic, this is unsurprising. With a higher number of referrals and the known potential for fewer staff owing to illness, we felt compelled to reinvent how we organised assessments of new referrals. Prior to our project, assessments were carried out at the soonest opportunity, without analysing the urgency of clinical need. Our new RAG (red, amber, green) triage system aimed to enable the team to structure the order of patient assessments according to their clinical need.

Method We conducted a literature review and from the resources generated we drafted guidance on triaging via allocation of a RAG status, whereby ‘red’ patients should be seen within 48 hours, ‘amber’ patients within 5 days and ‘green’ patients within 10 days. We selected a sample of patients over a 4 week period during which the RAG system was in place and compared the appropriateness of the order in which patients were assessed with data from a 4 week period prior to the RAG system being in place, for which we retrospectively allocated a RAG status.

Results We found that pre-RAG, 20% of patients were assessed outside of their RAG status timeframe. Furthermore, there were less urgent patients that were assessed before them. In contrast, we found that post-RAG, only 5% of patients were assessed outside of their RAG status timeframe. Importantly, there were no less urgent patients seen before them.

Conclusion The RAG system has proven useful in triaging patients according to their clinical need, thereby ensuring patients are seen in an appropriate order according to their need. It continues to be a useful tool for the team in managing new referrals during this period of recovery following the pandemic.

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