OBJECTIVES: Emergency department (ED) triage prioritizes patients based on urgency of care. This study compared agreement between two blinded, independent users of a Web-based triage tool (eTRIAGE) and examined the effects of ED crowding on triage reliability. METHODS: Consecutive patients presenting to a large, urban, tertiary care ED were assessed by the duty triage nurse and an independent study nurse, both using eTRIAGE. Triage score distribution and agreement are reported. The study nurse collected data on ED activity, and agreement during different levels of ED crowding is reported. Two methods of interrater agreement were used: the linear-weighted kappa and quadratic-weighted kappa. RESULTS: A total of 575 patients were assessed over nine weeks, and complete data were available for 569 patients (99.0%). Agreement between the two nurses was moderate if using linear kappa (weighted kappa = 0.52; 95% confidence interval = 0.46 to 0.57) and good if using quadratic kappa (weighted kappa = 0.66; 95% confidence interval = 0.60 to 0.71). ED overcrowding data were available for 353 patients (62.0%). Agreement did not significantly differ with respect to periods of ambulance diversion, number of admitted inpatients occupying stretchers, number of patients in the waiting room, number of patients registered in two hours, or nurse perception of busyness. CONCLUSIONS: This study demonstrated different agreement depending on the method used to calculate interrater reliability. Using the standard methods, it found good agreement between two independent users of a computerized triage tool. The level of agreement was not affected by various measures of ED crowding.
OBJECTIVES: Emergency department (ED) triage prioritizes patients based on urgency of care. This study compared agreement between two blinded, independent users of a Web-based triage tool (eTRIAGE) and examined the effects of ED crowding on triage reliability. METHODS: Consecutive patients presenting to a large, urban, tertiary care ED were assessed by the duty triage nurse and an independent study nurse, both using eTRIAGE. Triage score distribution and agreement are reported. The study nurse collected data on ED activity, and agreement during different levels of ED crowding is reported. Two methods of interrater agreement were used: the linear-weighted kappa and quadratic-weighted kappa. RESULTS: A total of 575 patients were assessed over nine weeks, and complete data were available for 569 patients (99.0%). Agreement between the two nurses was moderate if using linear kappa (weighted kappa = 0.52; 95% confidence interval = 0.46 to 0.57) and good if using quadratic kappa (weighted kappa = 0.66; 95% confidence interval = 0.60 to 0.71). ED overcrowding data were available for 353 patients (62.0%). Agreement did not significantly differ with respect to periods of ambulance diversion, number of admitted inpatients occupying stretchers, number of patients in the waiting room, number of patients registered in two hours, or nurse perception of busyness. CONCLUSIONS: This study demonstrated different agreement depending on the method used to calculate interrater reliability. Using the standard methods, it found good agreement between two independent users of a computerized triage tool. The level of agreement was not affected by various measures of ED crowding.
Authors: Dominik Aronsky; Ian Jones; Bill Raines; Robin Hemphill; Scott R Mayberry; Melissa A Luther; Ted Slusser Journal: AMIA Annu Symp Proc Date: 2008-11-06
Authors: Nasim Farrohknia; Maaret Castrén; Anna Ehrenberg; Lars Lind; Sven Oredsson; Håkan Jonsson; Kjell Asplund; Katarina E Göransson Journal: Scand J Trauma Resusc Emerg Med Date: 2011-06-30 Impact factor: 2.953
Authors: Ju Young Lee; Sang Hoon Oh; Eun Hee Peck; Jung Min Lee; Kyu Nam Park; Soo Hyun Kim; Chun Song Youn Journal: Scand J Trauma Resusc Emerg Med Date: 2011-11-03 Impact factor: 2.953
Authors: Pierre Elias; Ash Damle; Michael Casale; Kim Branson; Chaitanya Churi; Ravi Komatireddy; Jamison Feramisco Journal: JMIR Med Inform Date: 2015-06-10