Triage Accuracy and Its Association with Patient Factors Using Emergency Severity Index: Findings from United Arab Emirates

Abstract

Yousif AlSerkal,1 Kalthoom AlBlooshi,2 Sumaya AlBlooshi,3 Yasir Khan,4 Sadaf A Naqvi,4 Colin Fincham,4 Noor AlMehiri2 1Hospital Sector, Ministry of Health and Prevention, Dubai, United Arab Emirates; 2Hospital Department, Ministry of Health and Prevention, Dubai, United Arab Emirates; 3Nursing Department, Ministry of Health and Prevention, Dubai, United Arab Emirates; 4Cerner Middle East, Dubai, United Arab EmiratesCorrespondence: Sadaf A Naqvi Email [email protected]: The Ministry of Health and Prevention of the UAE acquired an electronic medical record system (Wareed) through which they incorporated the Emergency Severity Index as the standard triaging tool. This raised the need to review population dynamics and the accuracy of triage performed by the health-care providers utilizing the tool.Objective: This research aimed to study demographics and dynamics of the population presenting to emergency departments (EDs) during 2018, evaluate the accuracy of triage assessment using comparative analysis techniques, and determine relationships between patient factors (severity of illness, age-group) and the accuracy of triage.Methods: This was an observational study that aimed to ascertain findings from ED data over 1 year (January 2018–December 2018) and explore factors associated with reduced accuracy in acuity assignment. We employed comparative analysis to measure the level of agreement between standard guidelines and local findings.Results: A total of 576,154 patients visited EDs in 2018, of which 54.4% were male. A statistically significant increase in length of stay with increasing severity of illness was observed (Kruskal–Wallis test). Overall triage accuracy was 41.6%, with a positive association with increasing severity of illness. We found a positive association between severity of illness and accuracy of triage (OR 0.14, p=0). We also found on logistic regression that the age-group 11– 20 years had the highest probability of accurate triage acuity (R2=0.41, p=0).Conclusion: Conducted on a very large data set from the UAE, our study reflects upon population dynamics and triage accuracy distribution among different variables. This study paves the way for further in-depth analysis of factors that may impact triage accuracy within EDs, and utilizing a similar approach it can be replicated in other settings as well.Keywords: Emergency Severity Index, ESI, triage, electronic medical record

Keywords

• emergency severity index (esi) triage electronic medical record