The National Emergency Department Triage Quality Improvement Framework (2025–2027) responds directly to long-standing concerns from frontline teams and key recommendations to the report by former Chief Justice Frank Clarke SC. Launched in September 2025, the framework marks one of the most significant reform efforts to the triage process in Irish Emergency Departments. At its core, the initiative aims to restore triage to its essential purpose: rapid, safe clinical prioritisation in an increasingly complex and crowded ED environment.
Over time, triage in many EDs has expanded beyond its original scope, with staff carrying out additional tasks such as administering medications, initiating investigations, or delivering analgesia. While well-intentioned, these activities have lengthened triage times and increased risks for undifferentiated, potentially deteriorating patients. The new framework refocuses triage on clinical risk assessment while building stronger pre- and post-triage systems to support patient flow.
The QIP outlines clear objectives across three phases of care. Pre-Triage initiatives include digital self-registration and rapid streaming pathways that divert suitable patients away from the ED, reducing congestion and time to triage. Triage itself will be reinstated as a fast, prioritisation-only step. In the Post-Triage phase, structured assessment and early interventions such as the Emergency Medicine Early Warning System (EMEWS) and rapid initiation of care bundles will accelerate diagnostics, decision-making and multidisciplinary involvement.
A major emphasis of the framework is transparency and accountability. Key Performance Indicators (KPIs) will be monitored weekly, with monthly reports to Health Regions, enabling real-time visibility of flow challenges and informing resource planning and staffing models.
The impact of these reforms is already evident. At St. Luke’s General Hospital Kilkenny, the pre-triage streaming of GP-referred patients has significantly reduced duplication of assessments and improved access to the Acute Medical Unit, Paediatric Assessment Unit and other specialist pathways. Staff report smoother workflows, enhanced safety and better patient experiences.
Looking ahead, national communications will launch in early 2026, with the first KPI benchmarking review scheduled for Q2. As this multi-year programme progresses, it represents a coordinated national commitment to safer, faster and more effective emergency care.
