The Lived Experiences of Patients and Health Care Providers During ED Triage in Saudi Arabia

Triage in emergency departments is central to matching clinical urgency with timely emergency care, patient safety, and patient experience; yet little is known about how patients and health care providers experience triage in tertiary emergency departments in Saudi Arabia.

This qualitative descriptive study explored triage experiences in a tertiary emergency department in Riyadh, Saudi Arabia. Purposive sampling recruited 42 participants: 21 nurses, 11 physicians, and 10 patients. Data were generated through 35 semistructured individual interviews and 1 nurse focus group with 7 nurses from November 2024 to January 2025, across peak and off-peak periods. Guides were piloted. Data were transcribed verbatim, de-identified, and analyzed inductively using reflexive thematic analysis, emphasizing reflexive bracketing, repeated reading, coding, within- and cross-group comparisons, and consensus-based theme development.

Four themes and 12 subthemes described triage as shaped by system conditions: workforce and resource challenges; environmental and infrastructure barriers; organizational and contextual system-level factors; and improvement interventions. Participants linked triage difficulties to staffing and competency gaps, crowding and privacy limitations, workflow and communication failures, and delayed access to diagnostics and beds. Together, the themes showed that triage was experienced as a system-mediated encounter in which care priorities, communication, privacy, and flow were shaped by interactions among people, spaces, resources, and organizational routines.

Emergency department triage at this tertiary hospital in Saudi Arabia was perceived as a complex process shaped by staffing, communication, infrastructure, and organizational pressures. Patients, nurses, and physicians described how these interconnected factors affected timely care, patient safety, privacy, and the overall triage experience. Improving workforce support, triage training, communication, and emergency department resources may help to strengthen triage quality and enhance emergency care delivery and the patient experience.