?I WAS HERE FIRST, WHY DID THEY GO BEFORE ME?: EXAMINING PATIENTS'PERCEPTIONS OF PRIORITY IN A PSYCHOMETRIC STUDY OF EMERGENCY DEPARTMENT TRIAGE

Introduction: Unrealistic patient expectations for wait times can lead to poor satisfaction. This study's dual purpose was: (1) to address disparities between patients' perceived priority level and the Emergency Severity Index (ESI) assigned by emergency room triage nurses; and (2) to evaluate validity and reliability of using the Patient Perception of Priority to be Seen Survey (PPPSS) to investigate patient expectations for emergency department urgency.Methods: A two-group pretest-posttest quasi-experimental approach compared patient urgency opinions to nurse urgency ratings with and without a scripted educational intervention. This tested how closely patient perceptions were related to triage nurse ratings. Results: Reliability for the PPPSS was acceptable (reliability = 0.75). Patients who were rated lower urgency on the ESI by triage nurses tended to self-report higher urgency (rho =-0.44, P < .01). Attitudes were more consistent in the posttest patient group who were exposed to the scripted verbal descrip-tion of emergency department procedures (x2 (1, N = 352) = 8.09, P < .01). Patients who disagreed with emergency nurse scores tended to be younger on average (eg, < 40 years old; rho = 0.69, P < .01). Male identified patients tended to be rated both by nurses and themselves as higher urgency (beta = 0.18, P = .02).Discussion: We recommend the PPPSS for nurses and re-searchers to quickly assess patient expectations. Additionally, promoting patient understanding through a scripted educational strategy about the ESI system may also result in improvements in communication between patients and nurses.

Automated summary

This study aimed to address disparities between patients' perceived priority level and the Emergency Severity Index (ESI) assigned by nurses and evaluate the validity and reliability of using the Patient Perception of Priority to be Seen Survey (PPPSS) to investigate patient expectations for emergency department urgency. The results showed that the PPPSS can be a useful tool to assess patient expectations and that a scripted educational intervention improved communication and understanding between patients and nurses.