Establishing Research Priorities for the Emergency Severity Index Using a Modified Delphi Approach

Area of Science:

• Emergency Medicine
• Nursing Research
• Healthcare Quality Improvement

Background:

• The accuracy of initial Emergency Department (ED) triage decisions significantly impacts patient safety and clinical outcomes.
• The Emergency Severity Index (ESI), a 5-point acuity score, is widely used internationally and in 94% of US academic EDs.
• The Emergency Nurses Association now manages the Emergency Severity Index (ESI), focusing on its maintenance and improvement.

Purpose of the Study:

• To establish a comprehensive research agenda aimed at enhancing both individual and institutional understanding and utilization of the Emergency Severity Index (ESI).

Main Methods:

• A modified Delphi process involving three rounds of data collection was employed.
• Initial data collection identified 112 issues, refined into 18 potential research questions across four categories.
• Subsequent rounds involved establishing the importance and rank-ordering of these research questions and categories.

Main Results:

• Research questions were categorized into education and training (6), workplace environment (3), emergency care services (7), and special populations (2).
• A rank ordering of both categories and specific research questions was achieved through the Delphi process.
• The identified priorities align with existing gaps in the literature regarding ESI.

Conclusions:

• Priorities established through this modified Delphi process address critical gaps in current literature.
• Further research is recommended to address educational, environmental, and process challenges affecting emergency nurses' triage decisions and ESI accuracy.
• Encouraging research in these areas will improve the understanding and application of the Emergency Severity Index (ESI).