A new triage system for crowded emergency services; selftriage

The determinant of urgency is the patient and the perception of urgency by the patient is directly related to emergency department visits. The patient's high perception of urgency causes inappropriate emergency visits and overcrowding. Low urgency perception may increase the morbidity and mortality by preventing the patient from seeking emergency care services. In this study, it was aimed to compare the perception of urgency of the patient with the health professionals' urgency evaluation. Patients who were older than 18 years of age, admitted to Hacettepe University, Department of Emergency Medicine between June 1, 2018 and November 15, 2018, not categorized T1 or T2 triage according to the health professionals' triage, voluntarily accepted to participate in the study, were included in the study. Patients were asked to select the triage category best suited to their urgency from the five-triage category, where average waiting times were also given. When the patient triage and the health professionals' triage were compared; 26% (n = 769) of the patients chose the same triage category as the health professionals did, while 67% (n = 2012) did overtriage, and 6% (n = 178) did undertriage. In this study, the urgency perception of the patients and the urgency assessment of the health professionals were found to be different (kappa=0,041, ağırlıklı kappa=0,1585). Female gender, lower age average, admission for non-traumatic reasons, walk-in attendence, and discharge were found to be associated with overtriage. The incongruity with the extended matched patient triage group and the health personnel triage, which was formed by the inclusion of one category high patient triage and one category low patient triage in the compatible patient triage, was found to be incompatible (kappa=0,1133). Informing the community and raising awareness may contribute to the improvement of the patient's perception of urgency in the medium and long term. Providing counseling services to the patients about the urgency of their health conditions by primary care physicians face to face or with methods such as telemedicine via telephone or e-mail, can be effective in short and medium term.