title: A model of complaint based for overcrowding emergency department: Five-Level Hacettepe Emergency Triage System.
abstract: BACKGROUND
  To compare ESI Five-Level Triage System with 5-Level Hacettepe Emergency Triage System (HETS), which was developed for Overcrowded EDs in our country.
  
  
  METHODS
  Over a period of six days, patients were assessed by a different ED staff everyday using HETS, then re-evaluated blindly by an emergency physician using HETS. Then patients were evaluated blindly for a third time by an independent, ESI-using emergency physician.
  
  
  RESULTS
  Of the patients in the study, 133 were men, 175 were women and the average age was 44.41±18.033. Inter-rater agreement was 97.40% (Kappa=0.963) between HETS and HETS-Blind, 74.35% (Kappa=0.646) between HETS and ESI-Blind, 74.67% (Kappa=0.652) between HETS-Blind and ESI-Blind. Inter-observer agreement between the second emergency physician performing HETS-Blind and the first emergency physician, resident, or nurse was very good (Kappa=1.0). Intern doctor, non-medical secretary and paramedic were found to have almost very good agreement (Kappa=0.971; 0.935; 0.864, respectively). An overtriage of 7.25% and undertriage of 1.08% were found in HETS.
  
  
  CONCLUSIONS
  Complaint-based HEST developed for overcrowded Eds is a triage system with a very good agreement between observations and observers. Low undertriage and overtriage ratios, and easy application by all staff from a non-medical secretary to the emergency physician.
authors.affiliation: Department of Emergency Medicine, Hacettepe University, Ankara, Turkey. dogacniyazi@gmail.com
authors.forename: Doğaç Niyazi
authors.initials: DN
authors.lastname: Ozüçelik
authors.forename: Mehmet Mahir
authors.initials: MM
authors.lastname: Kunt
authors.forename: Mehmet Ali
authors.initials: MA
authors.lastname: Karaca
authors.forename: Bülent
authors.initials: B
authors.lastname: Erbil
authors.forename: Bülent
authors.initials: B
authors.lastname: Sivri
authors.forename: Ahmet
authors.initials: A
authors.lastname: Sahin
authors.forename: Yeşim
authors.initials: Y
authors.lastname: Cetinkaya Şardan
authors.forename: Mehmet Mahir
authors.initials: MM
authors.lastname: Ozmen
authors.forename: Bahar
authors.initials: B
authors.lastname: Güçiz Doğan
mesh_terms: D000328:Adult; D003441:Crowding; D004636:Emergency Service, Hospital / Q000458:organization & administration* / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014218:Triage / Q000379:methods* / Q000592:standards; D014421:Turkey