Assessing the Impact of the Emergency Severity Index Five-level Triage System at a County Hospital Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/163000
Type:
Presentation
Title:
Assessing the Impact of the Emergency Severity Index Five-level Triage System at a County Hospital Emergency Department
Abstract:
Assessing the Impact of the Emergency Severity Index Five-level Triage System at a County Hospital Emergency Department
Conference Sponsor:Emergency Nurses Association
Conference Year:2005
Author:Selman, Rhonda, RN, BS, CCRN
P.I. Institution Name:Lyndon Baines Johnson General Hospital
Title:Nurse Manager, Adult Emergency Center
Contact Address:5656 Kelley Street, Houston, TX, 77026, USA
Clinical Topic: This Level III trauma center emergency department (ED) triages an average of 200 to 220 patients a day, and most patients who require care have a length of stay between 8 and 30 hours. The number of patients leaving before treatment can be as high as 800 per month. The previous triage system included three levels of patient status to designate care. In an effort to provide more timely and appropriate care, the emergency department sought to implement a system that would consider resources when categorizing patients. Implementation of the Emergency Severity Index (ESI) Five-Level Triage System at this busy, urban county emergency department was integral to achieving positive patient outcomes, including appropriate triage designation, decreased overall length of stay, and improved patient satisfaction, as evidenced by a decrease in the number of patients leaving before treatment. Implementation: After a team of nurse managers conducted a literature review to investigate current successful options for triage, the ESI system was chosen because of its demonstrated efficacy in multiple hospital systems. The similarity of those systems to this emergency department was important in making the decision. Teams of nurses and physicians in the emergency department provided training to staff on all shifts for one month prior to implementation. The professional projects coordinator and the clinical educator developed a process for reviewing charts to evaluate appropriate triage designation by nursing staff. Outcomes: Data collection on the appropriateness of triage designation, length of stay, and patient satisfaction is currently underway. Appropriateness of triage designation is collected through monthly retrospective chart reviews. Patient satisfaction is measured by the number of patients leaving prior to treatment and the quantity of patient complaints. Patient satisfaction scores are evaluated for improvement. Preliminary data indicate that appropriate triage designation by nurses is conducted 85% of the time. In addition, the number of patients leaving prior to treatment decreased from 15% to 11% one month following implementation of the new triage system. Eight months of data will be available for statistical analyses by July 2005. Recommendations: Streamlining care through this five-level triage designation system can increase appropriate triage designation, decrease length of stay, and reduce the number of patients who leave the emergency department before receiving care. The ESI system assists the practitioner in identifying the priorities of care and has the potential for significantly improving both patient outcomes and satisfaction.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAssessing the Impact of the Emergency Severity Index Five-level Triage System at a County Hospital Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/163000-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Assessing the Impact of the Emergency Severity Index Five-level Triage System at a County Hospital Emergency Department</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2005</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Selman, Rhonda, RN, BS, CCRN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Lyndon Baines Johnson General Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nurse Manager, Adult Emergency Center</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">5656 Kelley Street, Houston, TX, 77026, USA</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: This Level III trauma center emergency department (ED) triages an average of 200 to 220 patients a day, and most patients who require care have a length of stay between 8 and 30 hours. The number of patients leaving before treatment can be as high as 800 per month. The previous triage system included three levels of patient status to designate care. In an effort to provide more timely and appropriate care, the emergency department sought to implement a system that would consider resources when categorizing patients. Implementation of the Emergency Severity Index (ESI) Five-Level Triage System at this busy, urban county emergency department was integral to achieving positive patient outcomes, including appropriate triage designation, decreased overall length of stay, and improved patient satisfaction, as evidenced by a decrease in the number of patients leaving before treatment. Implementation: After a team of nurse managers conducted a literature review to investigate current successful options for triage, the ESI system was chosen because of its demonstrated efficacy in multiple hospital systems. The similarity of those systems to this emergency department was important in making the decision. Teams of nurses and physicians in the emergency department provided training to staff on all shifts for one month prior to implementation. The professional projects coordinator and the clinical educator developed a process for reviewing charts to evaluate appropriate triage designation by nursing staff. Outcomes: Data collection on the appropriateness of triage designation, length of stay, and patient satisfaction is currently underway. Appropriateness of triage designation is collected through monthly retrospective chart reviews. Patient satisfaction is measured by the number of patients leaving prior to treatment and the quantity of patient complaints. Patient satisfaction scores are evaluated for improvement. Preliminary data indicate that appropriate triage designation by nurses is conducted 85% of the time. In addition, the number of patients leaving prior to treatment decreased from 15% to 11% one month following implementation of the new triage system. Eight months of data will be available for statistical analyses by July 2005. Recommendations: Streamlining care through this five-level triage designation system can increase appropriate triage designation, decrease length of stay, and reduce the number of patients who leave the emergency department before receiving care. The ESI system assists the practitioner in identifying the priorities of care and has the potential for significantly improving both patient outcomes and satisfaction.</td></tr></table>en_GB
dc.date.available2011-10-27T10:37:49Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:37:49Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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