Related Experiment Videos
Inconsistency of emergency department triage. Emergency Department Operations Research Working Group
R Wuerz1, C M Fernandes, J Alarcon
1Center for Emergency Medical Services, Penn State College of Medicine, Hershey, USA.
Annals of Emergency Medicine
|October 17, 1998
Summary
Emergency department triage systems show poor agreement between raters and within raters. This inconsistency challenges the reliability of current emergency department (ED) triage practices.
Area of Science:
- Emergency Medicine
- Healthcare Quality
Background:
- Emergency department (ED) triage systems aim to prioritize patients based on urgency.
- Reliability of triage assessments is crucial for effective patient care and resource allocation.
Purpose of the Study:
- To evaluate the interrater and intrarater agreement of existing emergency department triage systems.
- To assess the consistency of triage decisions made by healthcare professionals.
Main Methods:
- A 2-phase experimental study involving triage nurses and EMTs.
- Participants rated 5 standardized patient scenarios in in-person interviews and follow-up surveys.
Main Results:
- Poor interrater agreement on triage category (kappa = .347).
- Low intrarater reliability, with only 24% of participants rating cases consistently across phases.
- Significant discrepancies between severity ratings and recommended evaluation times.
Conclusions:
- Triage assessments by experienced personnel are inconsistent, impacting reliability.
- Current ED triage practices may not be consistently reliable based on these findings.