title: The Soterion Rapid Triage System: evaluation of inter-rater reliability and validity.
abstract: The Soterion Rapid Triage System is a new, computerized, five-level triage acuity system. The purpose of this study was to evaluate the system's inter-rater reliability and validity for stratifying patient acuity. The study was comprised of two components. A prospective evaluation of inter-rater reliability was conducted by the blinded, paired simultaneous triage of 423 patients. A retrospective evaluation of validity consisted of the analysis of 33,850 patients triaged with the system over an 8-month period. The system's validity was measured by in-hospital admission rate, Emergency Department (ED) length-of-stay, hospital charges and Current Procedural Terminology (CPT) Codes 99281-99285. Evaluation of inter-rater reliability demonstrated a weighted kappa of 0.87 (95% confidence interval 0.84, 0.91). The in-hospital admission rates for patients triaged as Level 1 Immediate-Level 5 Non-Urgent were 43%, 30%, 13%, 3% and 1%, respectively (p < 0.0001). Similarly, there were significant differences in the means for all hospital charges, ED lengths-of-stay, and CPT Codes. In conclusion, the Soterion Rapid Triage System possesses high inter-rater reliability and validity. The system's reliability and validity, and the availability of the system's electronically archived data are characteristics beneficial to the development of a national standardized five-level triage acuity system.
authors.affiliation: Freeman Health System. Joplin, Missouri 64804, USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Maningas
authors.forename: Derek A
authors.initials: DA
authors.lastname: Hime
authors.forename: Donald E
authors.initials: DE
authors.lastname: Parker
authors.forename: Ted A
authors.initials: TA
authors.lastname: McMurry
mesh_terms: D000465:Algorithms; D003658:Decision Making, Computer-Assisted; D016529:Emergency Nursing / Q000295:instrumentation*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D016037:Single-Blind Method; D014193:Trauma Centers; D014218:Triage / Q000379:methods*