Outcomes for Emergency Severity Index Triage Implementation in the Emergency DepartmentCorrespondence Address :
Mr. Amir Mirhaghi,
PhD Candidate, Department of Medical-Surgical Nursing, School of Nursing and Midwifery,
Mashhad University of Medical Sciences, Mashhad, Iran.
E-mail : email@example.com
Introduction: Hospital triage scale in emergency departments needs to be valid and reliable. Lack of sufficient data exists on triage scale rigor in emergency departments of Iran. This study aimed to determine the impact of the emergency severity index (ESI) triage scale in the emergency department.
Materials and Methods: A single-center study was conducted. Proportion of triage categories allocated to high-risk patients admitted to high-acuity departments was examined in observational period in June 2012 and May 2013. True triage score was reported based on patients` paper- based scenario questionnaire. Interrater reliability was assessed using unweighted kappa. Concordance among experts, nurses and physicians was examined. The Chi-square test and Kappa statistics was used for statistical analysis.
Results: Triage decisions regarding high-risk patients before and after implementation period are independent from each other (?2= 22.254; df=1; p<0.05) and more high-risk patients were recognized after implementation of the ESI. Overall agreement and concordance were (79%) and (?=0.54) among nurses; (71%) and (?=0.45) among physicians, (85%) and (?=0.81) among experts, respectively. Correct triage decisions among clinicians were increased after implementation of the ESI.
Conclusion: The ESI as valid and reliable tool improving desirable outcomes` in the emergency department has been recommended but it may not reveal optimal outcomes in developing countries comparing to what have been achieved in the developed countries. In addition, patient influx in ESI level II could create considerable controversy with clinicians.
Algorithm, ESI, Reliability
Amir Mirhaghi, Hadi Kooshiar, Habibollah Esmaeili, Mohsen Ebrahimi. OUTCOMES FOR EMERGENCY SEVERITY INDEX TRIAGE IMPLEMENTATION IN THE EMERGENCY DEPARTMENT. Journal of Clinical and Diagnostic Research [serial online] 2015 April [cited: 2019 Oct 18 ]; 9:OC04-OC07. Available from
Date of Submission: Oct 24, 2014
Date of Peer Review: Feb 02, 2015
Date of Acceptance: Feb 10, 2015
Date of Publishing: Apr 01, 2015
Financial OR OTHER COMPETING INTERESTS: None.
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