A four-level triage scale (the Geneva Emergency Triage Scale, GETS) has been used since 1997 in our emergency department (ED). A recent evaluation of this scale showed that our instrument had an excellent intra-rater reliability but insufficient inter-rater reliability. We also observed a wide variability in the way triage nurses perform (J Clin Epidemiology, 2006 in press). These variations in the triage process are mainly explained by a poor standardization of vital signs measurement. Therefore, we have recently modified our triage instrument and introduced explicit criteria for vital signs evaluation during the triage process.~The objectives of this study are:~To evaluate the inter- and intra-rater reliability of our modified triage scale using a computer simulator~To measure the impact of visual clues on the triage decisions when using the triage simulator~To evaluate the performance of triage nurses and chief physicians in their triage decisions.~We expect to observe:~an improvement of the inter-rater reliability of our instrument compared to the previous version~a better standardization and more systematic use of vital signs measurement~a higher reliability when visual clues are given to the evaluator~lower rates of under- and over-estimation of emergency levels.
A four-level triage scale (the Geneva Emergency Triage Scale, GETS) has been used since 1997 in our emergency department (ED). A recent evaluation of this scale showed that our instrument had an excellent intra-rater reliability but insufficient inter-rater reliability. We also observed a wide variability in the way triage nurses perform (J Clin Epidemiology, 2006 in press). These variations in the triage process are mainly explained by a poor standardization of vital signs measurement. Therefore, we have recently modified our triage instrument and introduced explicit criteria for vital signs evaluation during the triage process.~The objectives of this study are:~To evaluate the inter- and intra-rater reliability of our modified triage scale using a computer simulator~To measure the impact of visual clues on the triage decisions when using the triage simulator~To evaluate the performance of triage nurses and chief physicians in their triage decisions.~We expect to observe:~an improvement of the inter-rater reliability of our instrument compared to the previous version~a better standardization and more systematic use of vital signs measurement~a higher reliability when visual clues are given to the evaluator~lower rates of under- and over-estimation of emergency levels.