Focus of Study Clinical Trial
Official title:
A Nationwide Survey of Korean Emergency Department Triage Systems and Scales; a First Step Towards Korean Triage and Acuity Scale(KTAS)
As a first step towards reform of the emergency medical service system by standardizing triage scale to Korean Triage and Acuity Scale(KTAS), we aimed to assess the present status of our emergency department triage systems and illustrated the present status and problems of the Korean emergency department triage system.
Study design In Korea, EDs are classified into 4 levels, 21 4th degree regional EDs, 115 3rd
degree local EDs, 323 2nd degree local emergency facilities and 132 1st degree other
emergency facilities. Korea is divided into 21 medical regions according to access to
hospitals, the population of cities and their areas. A regional ED is located in each
medical region. There is a local ED for every million people in metropolitan areas, and
every five hundred thousand peoples in other cities. The investigators selected all 4th and
3rd degree EDs in Korea (21 regional and 115 local EDs; at Dec 31, 2011). The triage systems
of these EDs are qualified and controlled by the National Emergency Medicine Center. The
investigators conducted a telephone and e-mail survey of triage officers from September 4 to
November 27, 2012. The name of each center was identified from the 2011 Annual Report of
Korean Emergency Medicine, which included the phone number of each ED.6) Initially, an EM
specialist telephoned the nurse manager of all EDs and explained the purpose of the survey.
He then selected a triage officer from each ED who had worked in the emergency department
for more than 3 years. The interviewer first asked them whether they wanted a telephone
interview or the e-mail survey. 102 EDs chose the telephone interview, in which the
interviewer read the questions and noted the answers on the survey sheet in a standard order
to prevent interviewer bias. The investigators instructed the interviewer not to change the
wording or content of any survey question; however if a respondent did not understand the
meaning of a word, the interviewer was allowed to explain it. Thirty four EDs wanted to
answer by e-mail, and the investigators sent the survey form to them. If the answer did not
arrive after a week, the investigators sent the same e-mail again, and after two weeks the
investigators called the respondent again. In 4 cases the nurse manager of an ED or the
triage officer declined to answer the survey him/herself for security reasons. In those
cases, the investigators contacted the hospital administrator and asked him or her to
forward an e-mail to the ED triage officer or nurse manager.
Data collection and processing The survey instrument was revised by 6 emergency medicine
departments of 2 institutions. (The survey instrument is posted in online as a supplementary
file). Data collected included identification of respondents, actual usage of separate
triage rooms, occupations of triage officers, presence of documented triage scales, type of
triage scale, triage officer's opinion about the problem of his own triage scale, education
for the triage officers, and the process of reviewing their triage scales.
The investigators used SPSS 18 (IBM SPSS Inc., Chicago, Illinois, USA) for data management
and analysis. The investigators compared characteristics of the regional EDs with those of
local EDs and examined aspects of the ED triage systems such as frequency of use of the
triage room, occupation of the triage officer and so on. The investigators compared the
features of EDs with verified triage scales and those with unverified triage scales, and
assessed the quality control of the EDs by asking about education for triage, and
verification of the triage scale. This research was reviewed by the University of Hanyang
institutional review board and was exempted from written informed consent. Survey
respondents were informed that their participation was voluntary and that the results of the
survey would be kept confidential.
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Time Perspective: Cross-Sectional
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