Reliability and validity of a new French-language triage algorithm: the ELISA scale

Area of Science:

• Emergency Medicine
• Healthcare Management
• Clinical Nursing

Background:

• Emergency department (ED) overcrowding compromises patient care quality.
• Existing triage systems face generalization challenges due to international variations in emergency medical services.
• A localized, French-language triage system is necessary for specific healthcare contexts.

Purpose of the Study:

• To develop and validate a French-language triage algorithm, Echelle Liégeoise d'Index de Sévérité à l'Admission (ELISA).
• To assess the validity and efficiency of the ELISA triage system in a real-world setting.

Main Methods:

• ELISA, a five-category nursing triage algorithm, was implemented.
• Intrarater and interrater agreement were evaluated by comparing nurse classifications of clinical scenarios.
• Validity was assessed by correlating ELISA rankings with resource consumption and patient outcomes.

Main Results:

• High intrarater agreement was observed, with classifications statistically independent of the evaluating nurse.
• Near-perfect interrater agreement was found between nurses and a reference assignment, indicated by Cohen's κ coefficient.
• ELISA showed strong correlations with the need for supplementary clinical testing and patient outcomes.

Conclusions:

• The ELISA triage scale was developed to meet the need for a specific French-language tool in EDs.
• The study confirms ELISA as a valid triage tool with high reliability (interrater and intrarater agreement) and significant efficiency.