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

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 TRAIN™?

TRAIN™ is a trademarked algorithm 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. As part of regionalization, it is important that this algorithm remain standardized. All updates to the algorithm will be approved through the TRAIN(TM) Leadership Council and shared.

How and When TRAIN™ is used

Advantages and uses of TRAIN™ 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 transfer or discharge when surge capacity is required, and to enable expedient resource requests from other agencies.

Implementation of TRAIN™

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

Links to TRAIN™ algorithms

Contact Us

If you would like further information or would like to share comments or feedback, please email us at: TRAIN@stanfordchildrens.org