Nursing and Residential Triage Hub
Topic outline
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Nursing and Residential Triage
Welcome to the Nursing and Residential Triage Hub. Here you can learn about the history of the Manchester Triage System and how it's now used around the world. You can see how it could benefit your Organisation and try some sample teaching materials.
Current NaRT Instructors and Key Instructors can find all their resources by clicking on the buttons above or scrolling to the section you want. You must be logged in to see these sections.
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We’ve launched new Hub pages for each Manchester Triage System tool. These pages will contain everything you need to know about each tool from the background and methodology to Instructor teaching materials and resources. We hope these Hub pages will make it easier for you to find what you’re looking for. We’re still adding content to the pages so more things will appear over the next few weeks. We’re also revising our e-learning topics and will be launching those soon.
The new menu bar above contains links to all the Hub pages, as well as pages to help you navigate the rest of the site, access your current courses and contact us if you’ve got any questions.
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The
Nursing and Residential Triage (NaRT) tool has been designed specifically
for use within the Nursing and Residential Home setting by both nursing
and care home staff. It is based on the Manchester Triage System (MTS) and
is designed to integrate with a series of tools in other domains which are
all based on the same system:
- Emergency Triage: Emergency departments and Ambulance services
- Telephone Triage and Advice: Urgent care desks
- Prehospital Pathfinder: Ambulances
- Community Triage: Out of hours and Telemedicine providers; Telecare and Pendant providers; First responder organisations; Community assessment services
- SAFE pathways: Community-based clinicians
The six triage tools all share:- A reductive methodology identifying life threatening illnesses and injuries first
- A clinical risk management tool used Worldwide to safely manage patient flow when clinical demand exceeds capacity
- A common set of discriminators defined in a discriminator dictionary
- A shared language and common understanding
- Underpinning training packages and e-learning modules for practitioners
- A method of streaming for local implementation
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The principles of the Manchester Triage System are still followed with the use of the reductive methodology, however rather than choosing between 53 MTS presentational charts, the Nursing and Residential Triage tool comprises of just two charts; Illness and Injury.
Some discriminators and definitions have also been amended to enable both nurses and residential care workers to use the tool. Using the NaRT tool does not require a clinical decision to be made, rather it asks the person making the assessment to make their way through a list of presenting symptoms and, where the patient displays any of the symptoms on the list, the outcome should be followed.
Outcomes can be tailored to the availability of services in your area but in general the following services (or equivalent) would be required:- Ambulance service Clinical Hub, Single Point of Access or other locally agreed urgent care providers for amber outcomes
- GP, Out Of Hours GP or District Nurse available for green outcomes
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NaRT Licencing
Please click the headings below to learn more about licencing NaRT or one of the other Manchester Triage Systems products.
The key components are:- Obtaining a licence (details in this section)
- Accessing training for your instructors (online via the MTS website)
- Engaging with audit (see Audit and Accreditation section below)
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Licencing the use of MTS Clinical Risk Management Tools
The Manchester Triage System (MTS) is a series of clinical risk management tools used by clinicians worldwide to enable them to safely manage patient flow when clinical need far exceeds capacity. The following clinical risk management tools are available:- Emergency Triage: Emergency departments and Ambulance services
- Telephone Triage and Advice: Urgent care desks
- Prehospital Pathfinder: Ambulances
- SAFE pathways: Community-based clinicians
A formal governance structure for MTS ensures that training, audit and robust ongoing review is carried out routinely so that the tools stay safe, up-to-date and relevant to current practice.
The MTS tools are licenced to recognise the ownership of the intellectual property of MTS content and also to provide ongoing funding for the governance processes. The licencing agreement also provides a formal connection between the MTS and its end-users ensuring that end-users receive the correct training, engage in audit and are fully aware when updates are required.
The licencing process for MTS content is managed by Wiley on behalf of the Advanced Life Support Group and the Manchester Triage Group.
The first step is to register via our online portal to ensure that you understand the governance processes in terms of training, audit and licencing.
We have licencing options for:
- Software developers pre-populating with MTS content
- Software developers providing the framework for MTS but not pre-populating with MTS content
- Web-app developers pre-populating with MTS content
- End-users who purchase software pre-populated with MTS content
- End-users who purchase software with a framework but no MTS content embedded and then embed the MTS content in-house
- End-users who develop software in-house and integrate MTS content
- End-users who use paper-based systems to implement MTS content
The online portal is currently in beta format and if you have any feedback on its use, please email manchestertriage@alsg.org. The portal explains the rights and obligations of each option and the approach to and cost of licencing. Click here to start the process.
For end-users, one of the obligations is with regard to training and for Emergency Triage, Telephone Triage and Pathfinder an organisation is recognised as a Manchester Triage provider if it has instructors who have undertaken training with the Manchester Triage Group or with one of our International Reference Groups (see details in the instructor training section below)
Please read the liability statement here
Licencing the use of MTS Risk Management Tools
In recognition of the importance of safe decision-making in other settings, the Manchester Triage System (MTS) has been adapted with a Nursing and Residential Triage Tool (NaRT) and a Community Triage Tool (CoTT) for use in the following:
- Nursing and residential homes (NaRT)
- Out of hours and Telemedicine providers (CoTT)
- Telecare and Pendant providers (CoTT)
- First responder organisations (CoTT)
- Community assessment services (CoTT)
The principles of the Manchester Triage System are still followed with the use of the reductive methodology, however rather than choosing between 53 MTS presentational charts, these tools comprise just two charts; Illness and Injury.
Some discriminators and definitions have also been amended to enable both clinical and non-clinical staff in these settings to use the tools. Using these tools does not require a clinical decision to be made, rather it asks the person making the assessment to make their way through a list of presenting symptoms and, where the patient displays any of the symptoms on the list, the outcome should be followed.
Outcomes can be tailored to the availability of services in your area.
If you are interested in setting up any of these tools in a country, region or individual organisation, then the first step is to register via our online portal to ensure that you understand the governance processes in terms of training, audit and licensing.
Non-UK centres - book translation rights
For Emergency Triage and Telephone Triage only - if you are interested in translating the book for
use on local courses, please contact translationrights@wiley.com,
who will be able to check whether there is already a translation in your
language in the first instance. We prefer to license to local publishers to ensure that all translations are published on a proper legal footing and receive all due commercial support.
If you already have contacts with local publishers, we suggest you approach them in the first instance to find out if they might be interested in publishing a translation. If so, they would then need to contact Wiley at the email address above.We would ask that no translation work start before an Agreement is signed between Wiley and your selected local publisher.
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The Manchester Triage Accreditation Scheme
MTS Accreditation status will be awarded to a software company who:
- Provides a product that achieves the MTS IT specification
- Implements updates to their software and cascades the updates to all users of the software within the timeframes outlined by MTS
- Informs MTS in a timely way when they implement software within a new organisation
- Pays the licencing fees due within the Wiley settlement dates
- Pays the review and approval fees due to either MTS or their designated International Lead within their specified settlement dates
- Certifies that no changes have been made to the product that was signed off
MTS Accreditation status will be awarded to an end user organisation who:
- Implements a software solution that achieves the MTS IT specification
- Implements updates to their software within the timeframes outlined by MTS
- Pays the licencing fees due within the Wiley settlement dates
- Where appropriate, pays the review and approval fees due to either MTS or their designated International Lead within their specified settlement dates
- Has two trained instructors who have completed training with the national MTS instructors who then provide training to all of their triage practitioners and log this training on the MTS platform
- Applies the MTS Triage regulations and carries out audit
- Submits the annual audit data and compliance information
- Certifies that no changes have been made to the product that was signed off
To apply for MTS Accreditation status, complete this application form online.Accreditation, when awarded will be valid until an update is issued. At the point that a previous version of the tool expires (i.e. after three months for a patient safety update and six months for other updates), then organisations will be reminded and required to apply for re-accreditation.
Audit Tool
Audit is a key requirement for Organisations who implement Manchester Triage Tools. The standard for audit will be agreed with individual Organisations to take into account both safety and service demand.
We are currently developing an online Audit Tool which will be integrated into this online platform to support your audit activities locally and also to provide benchmarking. We will inform all Triage instructors once this system is live.
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NaRT Training Materials
Nursing and Residential Triage includes online course material and a self-directed learning package. You'll find the introductory e-module below along with the full list of e-modules available to registered providers.
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If you have any concerns about any of the discriminators and wish to report this issue to the Manchester Triage Advisory Groups, then please complete this e-form.
The Manchester Triage Advisory Group Chairs and Vice Chairs meet on a quarterly basis.If you indicate on the form that the issue may be a patient safety concern, then the issue will be considered immediately on receipt by the Manchester Triage Board.
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The Manchester Triage Group (MTG) support for editions of Nursing and Residential Triage is detailed below.
The MTG is clear that changes may include matters of Clinical Safety and that patients being triaged using previous editions may be at risk of mis-triage and may therefore have worse clinical outcomes.
MTG strongly advises all users not only to upgrade to the latest edition but also to ensure that any software provider is compliant with the critical update process that is now in existence.
MTG will not support users of previous versions/editions in court but will send a letter to the above effect to any medical negligence proceedings.
The Manchester Triage Group (MTG) will inform all licencees within 28 days about any patient safety updates.
For translated versions the International Reference Group (IRG) lead will be responsible for this notification.
It is the responsibility of the software company and their end users to ensure that their system is compliant with the updates.
Previous editions will not be supported after 3 months where there is a patient safety update and 6 months for general updates.
The latest update to Nursing and Residential Triage was in September 2020 and the current version is NaRT 1.2 It is important to ensure that you are licenced correctly and that you keep those details up-to-date so that we can contact you about updates.
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