More Patients Are Triaged Using the Emergency Severity Index Than Any Other Triage Acuity System in the United States
More Patients Are Triaged Using the Emergency Severity Index Than Any Other Triage Acuity System in the United States
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DOI：
10.1111/j.1553-2712.2011.01240.x
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发表时间：
2012-01-01
影响因子：
4.4
通讯作者：
Khare, Rahul K.
中科院分区：
文献类型：
--
作者：
McHugh, Megan;Tanabe, Paula;Khare, Rahul K.
目的：患者视力分诊系统在支持患者安全和急诊科(ED)手术中发挥着重要作用。2003年，美国急诊医师学会(ACEP)和急诊护士协会(ENA)的董事会批准了一项联合声明，呼吁医院采用可靠、有效的五级分诊分级标准，如紧急情况严重程度指数(ESI)。尽管如此，在美国，分诊敏锐度系统的使用似乎存在相当大的差异，许多医院使用的是三级和四级系统，这些系统尚未得到验证。这项工作的目的是衡量各种分诊敏锐度系统在美国医院的使用情况。方法：作者对二次资料进行横断面分析。数据来自2009年美国医院协会(AHA)年度调查问卷，该问卷邮寄给美国所有普通内科和外科医院。2009年，在调查中增加了一个关于医院在急诊室使用分诊系统的问题。描述性统计被用来探索不同类型医院使用的各种分诊敏锐度系统。结果：在接受调查的4897家医院中，82%的医院做出了回应，62%的医院(3024家医院)提供了急诊分诊系统的信息。2009年的数据显示，最常用的分诊系统类型是五级ESI(56.9%的受访医院)和三级分诊系统(25.2%)。超过70%的大型医院和教学医院使用ESI，未经验证的三级系统在小医院、公立医院、非教学医院和中西部医院更为常见。在我们的样本中，大多数(72.1%)急症患者去医院就诊是使用ESI进行评估的；只有13.1%的就诊是使用三级系统进行评估的。结论：在我们3000多家医院的样本中，ESI是最常用的分诊系统，使用ESI分诊的患者比任何其他分诊敏感度系统都要多。尽管如此，仍有机会进一步促进采用经过验证的、可靠的分类系统。
Objectives: Patient acuity triage systems can play an important role in supporting patient safety and emergency department (ED) operations. In 2003, the boards of the American College of Emergency Physicians (ACEP) and the Emergency Nurses Association (ENA) approved a joint statement calling for hospitals to adopt a reliable, valid, five-level triage scale such as the Emergency Severity Index (ESI). Still, there appears to be considerable variation in use of triage acuity systems in the United States, with many hospitals using three- and four-level systems that have not been validated. The purpose of this effort was to measure the use of various triage acuity systems in U.S. hospitals. Methods: The authors conducted a cross-sectional analysis of secondary data. Data were obtained from the 2009 American Hospital Association (AHA) Annual Surveyan intensive questionnaire mailed to all U.S. general medical and surgical hospitals. In 2009, a question was added to the survey about hospitals use of triage systems in EDs. Descriptive statistics were used to explore various triage acuity systems used by different types of hospitals. Results: Of the 4,897 hospitals surveyed, 82% responded, and 62% (3,024 hospitals) provided information on their ED triage system. The 2009 data revealed that the most commonly used triage system types were the five-level ESI (56.9% of responding hospitals) and three-level triage systems (25.2%). More than 70% of large hospitals and teaching hospitals use the ESI, and the unvalidated three-level systems were more common in small hospitals, public hospitals, nonteaching hospitals, and hospitals in the Midwest. The majority (72.1%) of all ED patient visits to hospitals in our sample were assessed using ESI; only 13.1% of visits were assessed using a three-level system. Conclusions: Among our sample of more than 3,000 hospitals, the ESI was the most commonly used triage system, and more patients were triaged using the ESI than any other triage acuity system. Still, there is an opportunity to further promote the adoption of validated, reliable triage systems.