AHRQ releases its new version of severity index

The U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality (AHRQ) has just released Emergency Severity Index (ESI) Version 4, an updated tool to help ED staff manage the flow of patients more effectively.

Version 4 of the AHRQ-funded ESI is a five-level patient triage formula that allows staff to judge quickly which patients need immediate attention and which could safely and more efficiently be treated in an urgent care center. The formula is based on the urgency of each patient’s condition and the extent of the hospital’s resources.

"This is a research-based system that has good reliability and validity," says Paula Tanabe, PhD, a research assistant professor in the department of emergency medicine at Northwestern University in Chicago.

Tanabe and a Northwestern colleague were members of the ESI research team that helped develop the original ESI algorithm, and they were asked by AHRQ to then conduct a "Translating Research Into Practice" project that ultimately led to the development of the training materials now available.

ESI Version 4 includes a set of two DVDs that give ED managers the information they need to decide whether to use the ESI, train ED nurses in the use of the triage tool, and implement the system. It includes more than 25 practice scenarios and information to help hospitals make the transition from Version 3 to the new system.

An accompanying Implementation Handbook provides additional information about triage, practice cases, and information on evaluation of the system.

"All of the slides can be downloaded and printed from the DVD, as can the actual algorithm," says Tanabe.


For more information on Emergency Severity Index Version 4, contact:

  • Paula Tanabe, PhD, Research Assistant Professor, Department of Emergency Medicine, Northwestern University, Chicago. Phone: (312) 926-6483. E-mail: p-tanabe@northwestern.edu.

ED professionals can order up to three copies of the program free by contacting: