Inconsistency of Emergency Department Triage

摘要: Abstract Study objective: To measure the interrater and intrarater agreement of existing emergency department triage systems. Methods: This 2-phase experimental study nurses' EMTs' ratings for 5 scripted patient scenarios used in-person interviews follow-up written surveys. Results: Eighty-seven participants (>90% those eligible) with 55 (63%) completed both phases study. Interrater on category was poor (κ=.347 overall). Only 13 (24%) rated cases same severity in phases; Kendall correlation (τ-B) comparing 1 2 varied from .145 to .554. Estimates admission probability widely. appropriate time physician evaluation (from immediate 24 hours) often incongruous (eg, 54% rating a case lowest recommended within 8 hours). There good estimated need an ED monitored bed or diagnostic studies. Conclusion: Triage assessments (both intrarater) by experienced personnel are inconsistent using these standardized scenarios. These results challenge reliability current practice. [Wuerz R, Fernandes CMB, Alarcon J, Emergency Department Operations Research Working Group: Inconsistency triage. Ann Emerg Med October 1998;32:431-435.]