Beruflich Dokumente
Kultur Dokumente
Type No of EDs %
Uses triage 413 93
3 level 193 45
4 level 47 11
CTAS 32 7
ESI 134 30
Evaluating Triage Systems
Validity and Reliability
• Validity
– Proxy measures for acuity include death
and hospitalization
• Reliability: Inter-rater
– Will nurses rate the same patient with the
same ESI rating?
– Measured with Weighted kappa (K)
– Range (0-1, no to perfect agreement)
Early work in ESI – Late 1990’s
• Drs’ Richard Wuerz and David Eitel devised the original
algorithm
80% BWH
LVH
60% UNC
York
40% Faulk
17th
20% Muhl
0%
1 2 3 4 5
Casemix
AHRQ Multi-center Study
60%
50%
BWH
40% LVH
UNC
30% York
Faulk
20% 17th
Muhl
10%
0%
1 2 3 4 5
ESI Version 4
ESI v.4 Materials
• Published May 2005
– ESI Implementation Handbook
– Educational DVDs
– Total requests: 17,142 (as of April 30, 2008)
• Goals
– measure the acceptance of the ESI by ED personnel
– assess the satisfaction training materials
– compare usefulness of the ESI with other similar triage tools
– determine what improvements users would like to see in the next
version of the products.
References
• Eitel D, Travers D, Rosenau A, Gilboy N, Wuerz R.
The Emergency Severity Index Triage Algorithm
Version 2 is Reliable and Valid. Academic
Emergency Medicine. 2003; 10(10) 1070-1080.
• Tanabe, P, Travers, D, Gilboy, N, Rosenau, A,
Sierzega, G, Rupp, V, Martinovich, Z, Adams, JG.
Refining emergency severity Index triage criteria.
Academic Emergency Medicine. 2005; 12(6): 497-
501.
Questions?
www.ahrq.gov/research/esi
Hotmail account: esitriageteam@hotmail.com