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Emergency Severity Index (ESI) Implementation Handbook, 2012 Edition

Table 8.3 Possible Triage Quality Improvement Indicators

Table 8.3 Possible Triage Quality Improvement Indicators

IOM AimsStructure, Process, OutcomesIndicatorData Source/Method
SafetyStructureImplementation of ESI (reliable and valid system)Administrative process
ProcessAssignment of correct ESI triage level (under and over triage levelsReview of triage note by triage expert
OutcomeReview of all negative outcomesReview by internal QI or triage committee
EffectivenessStructureImplementation of nurse initiated analgesic protocol at triageAdministrative policy
ProcessProportion of patients with pain eligible for analgesics at triage that received themMedical record review
OutcomeDecrease in patient reported pain score within 30 minutes of arrivalMedical record review
Patient-CenterednessProcessDocumentation of a subjective statement by the patient describing reason for visitMedical record and triage note
TimelinessProcessTime of arrival to time to physician evaluationMedical record review
EfficiencyStructureStaffing policy to allow flexibility in RN staffing pattern to meet the demands of changing influx of patients at triageAdministrative policy
ProcessIncreased RN's float to triage during increased influx and move to other patient care areas when triage demand is lowStaffing pattern log reviews
 Length of stay per ESI triage levelMedical record and triage note
 Admission rates per ESI triage levelMedical record and triage note
 Review of all ESI level 4 and 5 cases admitted to the hospitalMedical record and triage note
EquityProcessAll patients eligible for analgesics at triage according to the protocol receive them, regardless of gender or raceMedical record and triage note

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Current as of November 2011
Internet Citation: Emergency Severity Index (ESI) Implementation Handbook, 2012 Edition: Table 8.3 Possible Triage Quality Improvement Indicators. November 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/hospital/esi/esitab8-3.html