A total of 38 Emergency Department staff took the post-training assessment test.

The mean
score was high (86.3±5.4) and the scored ranged between 75 to 96. All passed the assessment
test.

Table 1. Level of Knowledge on ESI after Training among Emergency Department Staff

N=38
Mean score ± SD 86.3±5.4
Range 75-96
Passing rate (n, %) 38, 100%

In terms of inter-rater reliability of using ESI, 100% correctly identified the case for ESI 1 and
ESI 5. On the other hand, only 57.9% correctly identified the case for ESI 2, 63.1% for ESI 3
and 68.4% for ESI 4. Fleiss’s Kappa showed only slight agreement which indicates that scoring
of ESI in a patient among different raters may not be the same.

Table 2. Inter-rater Reliability of ESI among Emergency Department Staff

Actual Case Triage Levels

N=38 ESI 1 ESI 2 ESI 3 ESI 4 ESI 5
% correct rating by ED 38 (100%) 33 (57.9) 24 (63.1%) 26 (68.4%) 38 (100%)
staff
Fleiss’s Kappa Statistic 0.07, slight agreement
Among the 419 patients assessed in the ED, 6.7% were ESI 1, 11.5% were ESI 2, 36.3% were
ESI 3, 27.0% were ESI 4, and 18.6% were ESI 5.

6.7
18.6
11.5

27

36.3

ESI1 ESI2 ESI3 ESI4 ESI5

Figure 1. Patient distribution by ESI level (N=419)

Patient admission rates differed significantly across ESI levels (p-value <0.0001). The highest
admission rate was among ESI 1 patients (85.7%) while the lowest rate was observed among
ESI 5 patients (0.0%).

Chi-square =240.5 , p-value <0.0001

120

100 95.8
Percent of Paients Admitted

85.7
80

60

40
21
20
2.65 0
0
ESI1 ESI 2 ESI 3 ESI 4 ESI 5
ESI Triage Levels

Figure 2. Comparison of Patient Admission Rates Across ESI Triage Levels (N=419)
Patient mortality rates differed significantly across ESI levels (p-value <0.0001). The highest
mortality rate was among ESI 1 patients (71.4%) while the lowest rate was observed among ESI
4 and 5 patients (0.0%).

Chi-square =176.5 , p-value <0.0001

80
71.4
70

60
Mortality Rates

50

40
29.2
30

20

10
3.3
0 0
0
ESI1 ESI 2 ESI 3 ESI 4 ESI 5
ESI Triage Levels

Figure 3. Comparison of Mortality Rates Across ESI Triage Levels (N=419)

Patient mean length of hospital stay differed significantly across ESI levels (p-value <0.0001).
The highest mean length of hospital stay was among ESI 1 patients (4.2) while the lowest was
observed among ESI 4 and 5 patients (less than 24 hours).

ANOVA= 97.1, p-value<0.0001

5.9
4.2

1.6 <1 <1

Figure 4. Comparison of Mean Length of Hospital Stay Across ESI Triage Levels
(N=419)
Patient mean number of resources used differed significantly across ESI levels (p-value
<0.0001). The highest mean number of resources used was among ESI 1 patients (5.0) while
the lowest was observed among 5 patients (0.4).

ANOVA= 576.0, p-value<0.0001

5.0 5.0

3.0

1.7
5

0.4

Figure 5. Comparison of Mean Number of Resources used Across ESI Triage Levels
(N=419)