Exploring the Experiences of Emergency Department Healthcare Personnel in the Implementation of Triage Standard Policies: Basis for a Proposed Standard Triage Protocol

This qualitative descriptive study explored the experiences, challenges, and perceptions of emergency department (ED) healthcare personnel in implementing triage standard policies in a selected government hospital in Quezon City, Philippines. Guided by Roy's Adaptation Model, semi-structured interviews were conducted with nine ED registered nurses and head nurses, and data were analyzed using Braun and Clarke's six-phase reflexive thematic analysis. Five major themes emerged: (1) Triage Balancing Act; (2) Overcrowding Pressures; (3) Patient Prioritization; (4) Interprofessional Collaboration; and (5) Systemic Improvements. Findings revealed that while the Red-Yellow-Green zoning framework effectively prioritizes critically ill patients, its success depends on adequate staffing, institutional support, and resource availability. Participants identified overcrowding, staffing shortages, role ambiguity, and public misunderstanding as significant challenges. The study was conducted in a single secondary-level government hospital, which may limit transferability, suggesting future multi-site and quantitative research. Recommendations include implementing electronic triage documentation, surge staffing models, simulation-based competency training, and public education strategies. A proposed standard triage protocol was developed to bridge the policy-practice gap and enhance emergency care delivery. This study addresses the limited qualitative research on ED triage implementation in the Philippine setting, providing frontline insights that contribute to improving triage policies, clarifying professional roles, and advancing emergency nursing practice.