Emergency Severity Index (ESI): A Triage Tool for Emergency Department

Table 8.3 Possible Triage Quality Improvement Indicators

IOM Aims Structure, Process, Outcomes Indicator Data Source/Method
Safety Structure Implementation of ESI (reliable and valid system) Administrative process
Process Assignment of correct ESI triage level (under and over triage levels Review of triage note by triage expert
Outcome Review of all negative outcomes Review by internal QI or triage committee
Effectiveness Structure Implementation of nurse initiated analgesic protocol at triage Administrative policy
Process Proportion of patients with pain eligible for analgesics at triage that received them Medical record review
Outcome Decrease in patient reported pain score within 30 minutes of arrival Medical record review
Patient-Centeredness Process Documentation of a subjective statement by the patient describing reason for visit Medical record and triage note
Timeliness Process Time of arrival to time to physician evaluation Medical record review
Efficiency Structure Staffing policy to allow flexibility in RN staffing pattern to meet the demands of changing influx of patients at triage Administrative policy
Process Increased RN's float to triage during increased influx and move to other patient care areas when triage demand is low Staffing pattern log reviews
  Length of stay per ESI triage level Medical record and triage note
  Admission rates per ESI triage level Medical record and triage note
  Review of all ESI level 4 and 5 cases admitted to the hospital Medical record and triage note
Equity Process All patients eligible for analgesics at triage according to the protocol receive them, regardless of gender or race Medical record and triage note

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Page last reviewed October 2014
Internet Citation: Table 8.3 Possible Triage Quality Improvement Indicators. October 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/hospital/esi/esitab8-3.html