title: Emergency Severity Index (ESI) triage algorithm: trends after implementation in the emergency department.
abstract: The Emergency Severity Index (ESI) is a five-level emergency department triage algorithm that provides stratification of patients on the basis of acuity and resource needs, being ESI-1 the highest acuity and ESI-5 the lesser. The ESI triage system was recently adopted at our Emergency Department. We suspect higher acuity patients are facing inappropriate stratification and thus waiting longer to be managed and stabilized.
  
  
  METHODS
  A retrospective review of 100 charts was performed to calculate ESI accuracy by triage nurses and the time waiting to be seen by a physician.
  
  
  RESULTS
  41% of the patients were assigned an ESI level of lesser acuity, while 31.6% received the same score as calculated retrospectively. Retrospective ESI-2 patients that were assigned an ESI-4 upon triage faced inappropriate high median waiting time of 58 minutes.
  
  
  CONCLUSIONS
  The ESI assigned upon arrival correlated with the median waiting time, exposing undertriaged patients to longer waiting times.
authors.affiliation: Emergency Medicine Department, University of Puerto Rico, School of Medicine, Puerto Rico Health Science Campus, San Juan, PR. juan.gonzalez30@upr.edu
authors.forename: Juan
authors.initials: J
authors.lastname: González
authors.forename: Roxana
authors.initials: R
authors.lastname: Soltero
mesh_terms: D000465:Algorithms; D004630:Emergencies / Q000451:nursing*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D009730:Nursing Assessment; D009733:Nursing Diagnosis; D011647:Puerto Rico; D011785:Quality Assurance, Health Care; D012189:Retrospective Studies; D012494:Sampling Studies; D012720:Severity of Illness Index; D013997:Time Factors; D015599:Trauma Severity Indices; D014218:Triage / Q000592:standards*