The sample size was 9653. The studies were conducted in four countries (Canada, Iran, Korea and the United States). The year of publication of the studies was from 1999 to 2015 (median: 2009). 75 per cent of all studies were conducted with the latest version of the triage scale. All studies have used inter-board reliability. The weighted coefficient was the most widely used statistic (Table 1). The total consolidation coefficient was 0.756, this indicates a significant match between doctors and nurses (95% confidence interval [IC]: 0.659-0.823; value z: 10,410, P < 0.001, model Q: 984.176, df: 11, P – 0.001; Figure 2). We have bivariate associations between the intergovernmental agreement and other variables, including sociodemographic factors (age, gender, employment status, income, education, country of birth, indigenous status, order of life, social support, self-efficacy), health factors (perceived health status, emergency, severity and pain, pre-participation in Ed, method of arrival) and reasons for participating in ED. Table 3 presents factors that have been significantly associated with an inter-rated agreement (only statistically significant associations with p ≤ 0.05 were reported).
With respect to the assigned triage code, there has been moderate convergence between nurses and this adjudication committee. However, there was only a small agreement between the adjudation organ and the gastroenterologist. Many triage decisions can be directly based on national and local triage criteria. While the information provided by stakeholders does not always allow for an evaluation on the basis of these criteria, if the information is sufficient and the clinical situation meets the agreed criteria, the decision-making for triage can be simple. We assumed that standardization of this approach and delegation to experienced endoscopy nurses could reduce triage load for endoscopist triaging, while preserving the quality and consistency of triage decision-making. Can BurstrumM L, Nordberg M, Ornung G, Castrén M, Wiklund T, Engstrom M et al (2012) Team triage led by the doctor on the basis of lean principles be superior to efficiency and quality? A comparison of three emergency departments with different triage models. Scand J Trauma Resusc Emerg Med 20;20:57 (Aug) A major clinical concern is the subgroup of patients (20%) who tended to underestimate their priority over healer evaluations. Our study showed no statistically significant factors that could influence this perception. However, in this group, there are significant clinical risks that reinforce the need for professional assessment, active and ongoing management of the triage process, and professional monitoring of those on standby. Further research is needed to identify the characteristics of those who tend to overestimate or underestimate their urgency, as well as to understand whether there is a link between personality type and expectations of higher or lower triage scores.
The importance of pain assessment as a key determinant of patient perception of intrusion is important, as there are important influences of personality and culture not only on the perception of pain, but also on the public expression of that perception . Our results are consistent with a recent study of the consistency between patients and physicians in a Norwegian emergency ambulance on patient and physician compliance .