Objective: To access the validity and reliability of triage nurse estimates of ED patient complexity.
Methods: Prospective, single-blinded evaluation of triage nurse estimates of patient complexity, where a high-complexity patient is defined as a patient requiring two or more procedures or investigations or consultations. Validity of complexity estimates was assessed by comparison with the number of actual procedures, investigations and consultations requested. Reliability of triage nurse estimates of complexity was assessed by comparison with assessment nurse estimates of complexity.
Results: The specific proportion of agreement and spearman correlation coefficient of triage nurse estimates of complexity with actual procedure, investigations and consultation use were 0.83 (95% confidence interval [CI] 0.79-0.88) and 0.59 (95% CI 0.51-0.66), respectively. The specific proportion of agreement and kappa of triage nurse estimates of complexity with assessment nurse estimates were 0.80 (95% CI 0.73-0.87) and 0.59 (95% CI 0.47-0.71), respectively.
Conclusions: Triage nurses make valid and reliable estimates of patient complexity. This information might be used to guide ED work flow and ED casemix system analysis.