A model of complaint based for overcrowding emergency department: Five-level hacettepe emergency triage system

Doǧaç Niyazi Özüçelik, Mehmet Mahir Kunt, Mehmet Ali Karaca, Bülent Erbil, Bülent Sivri, Ahmet Şahin, Yeşim Çetinkaya Şardan, Mehmet Mahir Özmen, Bahar Güçiz Doǧan

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


BACKGROUND To compare ESI Five-Level Triage System with 5-Level Hacettepe Emergency Triage System (HETS), which was developed for Overcrowded EDs in our country. METHODS Over a period of six days, patients were assessed by a different ED staff everyday using HETS, then re-evaluated blindly by an emergency physician using HETS. Then patients were evaluated blindly for a third time by an independent, ESI-using emergency physician. RESULTS Of the patients in the study, 133 were men, 175 were women and the average age was 44.41±18.033. Inter-rater agreement was 97.40% (Kappa=0.963) between HETS and HETS-Blind, 74.35% (Kappa=0.646) between HETS and ESI-Blind, 74.67% (Kappa=0.652) between HETS- Blind and ESI-Blind. Inter-observer agreement between the second emergency physician performing HETS-Blind and the first emergency physician, resident, or nurse was very good (Kappa=1.0). Intern doctor, non-medical secretary and paramedic were found to have almost very good agreement (Kappa=0.971; 0.935; 0.864, respectively). An overtriage of 7.25% and undertriage of 1.08% were found in HETS. CONCLUSION Complaint-based HEST developed for overcrowded EDs is a triage system with a very good agreement between observations and observers. low undertriage and overtriage ratios, and easy application by all staff from a non-medical secretary to the emergency physician.

Translated title of the contributionAşırı kalabalık aciller için şikayet temelli bir model: Beş-düzeyli hacettepe acil triyaj sistemi
Original languageEnglish
Pages (from-to)205-214
Number of pages10
JournalUlusal Travma ve Acil Cerrahi Dergisi
Issue number3
Publication statusPublished - 2013
Externally publishedYes


  • Complaint-based triage system
  • Emergency medicine department
  • Emergency severity index
  • Hacettepe emergency triage system
  • Triage


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