Triage of Non-urgent Ambulatory Patients by Family Medicine Resident in Emergency Room

ABSTRACT

BACKGROUND: This study was performed to evaluate the validity of triage of non-urgent ambulatory patients using Triage Tool, the Emergency Severity Index-4 by a family medicine resident in the emergency room (ER). METHODS: A total of 790 ambulatory patients who visited an urban ER between March and April 2007 were enrolled. A family medicine (FM) resident and emergency medicine (EM) residents independently evaluated the severity of patients with ESI-4, and reviewed the basic characteristics and disposition of the patients. Concurrent validity and predictive validity were measured using weighted kappa analysis and chi-square analysis. RESULTS: Concurrent validity was good. The weighted kappa value was 0.910 between an FM resident and EM residents. The hospitalization rate was 75% in catergory 2 and 19.6%, 2.5%, 0.05% in category 3 through 5, respectively. More severe category patients of ESI-4 had higher rate of hospitalization rate. CONCLUSION: Triage by a family medicine resident, using the Emergency Severity Index-4 in ambulatory patients of emergency room (ER) is a useful screening tool for non-urgent patients.