Associations Between Emergency Severity Index and Patient Experience of Care in the Emergency Department

An optimally functioning emergency department (ED) sometimes must prioritize patients with time-sensitive conditions at the expense of longer wait times for others. Formalization of this process is known as triage. The Emergency Severity Index (ESI), the standard for ED triage in the United States, is a five-level triage algorithm that uses objective criteria to classify ED patients from 1 (most urgent) to 5 (least urgent), according to acuity and resource needs. Although surveys of ED patient experiences are commonly used for both quality improvement and business purposes, few published studies describe whether ED patient experience of care varies by severity classification at triage. If necessary prioritization affects reported experiences of care in the ED, then analyses that ultimately may inform operational changes (e.g., quality improvement initiatives) should explicitly adjust for prioritization. This study examines the association between ESI triage classification and reported patient experience in the ED.