Form #1 Form #1 ED professionals survey

Form Approved
OMB No. 0935-XXXX
Exp. Date XX/XX/20XX

ATTACHMENT B:
ED PROFESSIONALS SURVEY
SU_ID:

Some text

GENERAL INSTRUCTIONS
Answer all the questions by checking the box to the left of your answer. You are
sometimes told to skip over some questions in this survey. When this happens
you will see an arrow with a note that tells you what question to answer next,
like this:
1
2

Yes  Go to Question 2
No

Public reporting burden for this collection of information is estimated to average 20 minutes per response, the
estimated time required to complete the survey. Send comments regarding this burden estimate or any other aspect
of this collection of information, including suggestions for reducing this burden, to: AHRQ Reports Clearance
Officer Attention: PRA, Paperwork Reduction Project (0935-XXXX) AHRQ, 540 Gaither Road, Room # 5036,
Rockville, MD 20850

ED Professionals Survey
5.

SECTION I: BACKGROUND
1a. Do you work for a hospital?
1
2

Yes
No  [SKIP TO SECTION IV]

6.

1b. Do you work for an emergency department
(ED)?

2.

3.

4.

1

Yes

2

No

7.

Yes

2

No

Is this hospital part of a multi-hospital
corporation?
1

Yes

2

No

1

Yes

2

No

Is your ED staffed 24 hours per day/ seven
days per week?
1

Yes

2

No

What is the market served by your ED?
(Check all that apply.)
Please check rural if more than 10% of
your ED visits/yr are from patients living in
rural areas. Please check suburban if more
than 10% of your ED visits/yr are from
patients living in suburban areas. Please
check urban if more than 10% of your ED
visits/yr are from patients living in urban
areas.

Is this hospital associated with a medical
school?
1

Is your facility a Critical Access Hospital?

1
2
3

What type of hospital do you work for?

8.

1

Government-owned facility
(owned by the federal government
or a state, county, or municipal
government)
2
Privately-owned/ nonprofit facility
3
Investor-owned/ for-profit facility

Rural
Suburban
Urban

Which of the following best describes your
job in the hospital?
1

Emergency Department Nurse Manager
2
Emergency Department Medical Director
3
Emergency Department Director of
Nursing
4
Nurse Educator
5
Emergency Physician
6
Emergency Nurse
7
Emergency Technician
8
Medical Assistant
9
Administrative/ Clerical Staff
10
Resident
11
Other (please specify):



9.

What was the ED’s annual number of
patient visits in 2007?
1
2
3
4
5
6

11a. Are you aware of the Emergency Severity
Index (ESI) 5-level triage methodology?

5,000 visits
5,000 – 24,9999 visits
25,000 – 49,999 visits
50,000 – 99,999 visits
100,000 – 499,999 visits
500,000 – 1,000,000 visits

1
2

11b. How did you first become aware of the
ESI?
1

Agency for Healthcare Research and
Quality (AHRQ) website
2
AHRQ, other than the website
3
Emergency medical conference
4
Professional conference other than
for emergency medicine
5
Used in my ED
6
Published literature
7
Medical school coursework
8
Word of mouth
9
Other (please specify):

10. How frequently are patients “boarded” in
your ED for more than four (4) hours?
The Institute of Medicine defines “boarding” as
the practice of holding patients in the ED who
need to be admitted to the hospital because
an inpatient bed is not available.
5
4
3
2
1
0

Yes  Go to Question 11b
No

Very Frequently
Frequently
Sometimes
Rarely
Very Rarely
N/A

12. Does your emergency department use the
ESI as its primary emergency department
triage tool for every day use (noncatastrophic situations)?
Yes  [IF YES, USERS

COMPLETE SECTION II]
2
No  [IF NO, NONUSERS
COMPLETE SECTION III]
1



SECTION II. USERS OF ESI
3.

The following questions are about the use of
the ESI in your ED.
1.

What other type of triage system does your
emergency department use?
1

2 levels – emergent, non-emergent
2
3 levels – emergent, urgent, nonurgent
3
4 levels – life threatening, emergent,
urgent, nonurgent
4
5 levels – resuscitation, emergent,
urgent, nonurgent, referred
5
Other (please specify)

How long has your ED used ESI as the
primary triage tool?
1
2
3
4
5
6
7
8

< 3 months
3 – 6 months
6 months to 1 year
1 to 2 years
2 to 3 years
3 to 5 years
More than 5 years
Other (please specify)

4.

For what purpose(s) is an alternative triage
method used in your ED? Please describe
your answer in the box below.

9

2.

5.

Don’t know

Does your ED use other tools for triage in
addition to the ESI (for example, as part of
a community-wide catastrophe response
plan)?
1

Yes

2

No  [SKIP TO QUESTION 5]

What aspects of the ESI were most influential in helping your ED to choose the ESI as the primary
triage algorithm? Please select ALL that apply.
Most
important

important

Somewhat
important

Not
important

Least
important

Don’t
know

a. Ease of use

5

4

3

2

1

0

b. Ability to sort patients clinically

5

4

3

2

1

0

c. Ability to predict ED resource demand

5

4

3

2

1

0

d. Ability to plan staffing levels

5

4

3

2

1

0

e. Ability to facilitate patient flow

5

4

3

2

1

0

5

4

3

2

1

0

5

4

3

2

1

0

f. Effectiveness in every day
surge planning
g. Other (please specify)



6.

In what ways, if at all, did the ESI have to
be adjusted in order for it to work with your
ED’s operation?

We are interested in how the ESI compares to
other triage tools.
9.

What triage system did your emergency
department use prior to implementing the
ESI? Please select one answer.
1

7.

Are you satisfied with ESI as a triage tool?
5

Very satisfied

4

Satisfied

3

Somewhat satisfied
Not really satisfied
Not at all satisfied

2
1

8.

We are interested in the extent to which the
ESI has improved emergency services, and
surge planning and preparations in your
ED. Please rate each of the following.

a. Emergency services

2

Strongly
improved

Improved

Somewhat
improved

Did not
improve

Don’t
know

5

4

3

2

1

3

4

5

6

7

8

9
Don’t know
10
My ED did not have a formal triage
system in place prior to the ESI

b. Surge Planning and Preparations
Strongly
improved
5

Somewhat
Improved improved
4

3

Did not
improve

Don’t
know

2

1

2 levels – emergent, non-emergent
3 levels – emergent, urgent, nonurgent
4 levels – life threatening, emergent,
urgent, nonurgent
5 levels – Australasian Triage Scale
(ATS) formerly National Triage Scale of
Australia – resuscitation, emergent,
urgent, semi-urgent, nonurgent
5 levels – Manchester – immediate,
very urgent, urgent, standard, nonurgent
5 levels – Canadian Triage and Acuity
Scale (CTAS) – resuscitation, emergent,
urgent, less urgent, nonurgent
5 levels – Other triage system/Don’t
know the name of the triage system
Other (please specify)

10. Do you have familiarity with other triage
systems? Select the ONE that you are most
familiar with.
1
2
3

4

5

6

7

8

2 levels – emergent, non-emergent
3 levels – emergent, urgent, nonurgent
4 levels – life threatening, emergent,
urgent, nonurgent
5 levels – Australasian Triage Scale
(ATS) formerly National Triage Scale of
Australia – resuscitation, emergent,
urgent, semi-urgent, nonurgent
5 levels – Manchester – immediate,
very urgent, urgent, standard, nonurgent
5 levels – Canadian Triage and Acuity
Scale (CTAS) – resuscitation, emergent,
urgent, less urgent, nonurgent
5 levels – Other triage system/Don’t
know the name of the triage system
Other (please specify)



9

None of the above [SKIP TO QUESTION 12]

11. For each characteristic, please rate whether you feel that the ESI is a better or worse tool for every
day use (non-catastrophic situations) when compared to the other ED triage system that you are
most familiar with.
ESI is Much
Better than
other tool

ESI is
Better than
other tool

ESI is About
the Same
ESI is
As other
Worse than
tool
other tool

ESI is Much
Worse than
other tool

Don’t
Know

a. Ease of implementation

5

4

3

2

1

0

b. Ease of use

5

4

3

2

1

0

c. Sorting patients clinically

5

4

3

2

1

0

d. Predicting ED resource demand

5

4

3

2

1

0

e. Planning staffing levels

5

4

3

2

1

0

f. Facilitating patient flow in the ED

5

4

3

2

1

0

g. Planning for every day surges

5

4

3

2

1

0

h. Overall effectiveness

5

4

3

2

1

0

i. Other (please specify):

5

4

3

2

1

0

The following questions are about the ESI training materials. Please rate the ESI training DVDs and
accompanying booklet according to the following:
12. Did you receive the ESI training materials?
1
2

Yes
No

13. Have you viewed the ESI training DVDs?
1
2

Yes
No

14. Have you read the ESI handbook?
1

Yes

2

No



15. Please rate the ESI handbook according to the following categories.
Excellent

Good

Moderate

Poor

Very poor

Don’t know

a. Production Quality

5

4

3

2

1

0

b. Format

5

4

3

2

1

0

c. Organization

5

4

3

2

1

0

d. Readability

5

4

3

2

1

0

e. Appropriateness of the reading level

5

4

3

2

1

0

f. Appropriateness for ED triaging staff

5

4

3

2

1

0

g. Appearance

5

4

3

2

1

0

h. Comprehensiveness

5

4

3

2

1

0

16. Please rate the ESI DVDs according to the following categories.
Excellent

Good

Moderate

Poor

Very poor

Don’t know

a. Production Quality

5

4

3

2

1

0

b. Format

5

4

3

2

1

0

c. Organization

5

4

3

2

1

0

d. Appearance

5

4

3

2

1

0

e. Sound

5

4

3

2

1

0

f. Ability to convey instructions

5

4

3

2

1

0

g. Believability of the situations

5

4

3

2

1

0

5

4

3

2

1

0

i. Helpfulness for training ESI staff

5

4

3

2

1

0

j. Ease of viewing on computer

5

4

3

2

1

0

k. Ease of viewing on DVD player

5

4

3

2

1

0

l. Comprehensiveness

5

4

3

2

1

0

h. Appropriateness of the example
situations

17. Please rate how effective the materials were in teaching you about the ESI.
Very
effective

Effective

Somewhat
effective

Not very
effective

Not at all
effective

Don’t
know

a. ESI Handbook

5

4

3

2

1

0

b. ESI DVDs

5

4

3

2

1

0

18. Please rate how helpful the training materials were in preparing you to implement the ESI
in your ED.
Very
helpful

Helpful

Somewhat
helpful

Not very
helpful

Not at all
helpful

Don’t
know

a. ESI Handbook

5

4

3

2

1

0

b. ESI DVDs

5

4

3

2

1

0



23. How familiar are you with the Agency for
Healthcare Research and Quality (AHRQ)
and its mission?

19. Please rate the ease with which the ESI
was implemented in your ED.
Very
easy
5

Easy
4

Moderately Not very Not at all
easy
easy
easy
3

2

1

Don’t
know
0

20. Approximately how long did it take to
implement the ESI, from the time you
began planning and training staff to the
actual implementation of the system in
your ED?

2
3
4

21. Does your ED use the ESI training
materials (the DVDs and/ or accompanying
handbook) to train ED staff about the ESI?
Yes

2

No

3

Don’t know

A little
familiar

Not really
familiar

Not at all
familiar

5

4

3

2

1

Very
familiar

Familiar

A little
familiar

Not really
familiar

Not at all
familiar

5

4

3

2

1

25. This is AHRQ’s first assessment of
the ESI methodology and supporting
materials. AHRQ wants the ESI and
supporting materials to be as helpful as
possible. Please take this opportunity to
provide feedback on any aspect of the ESI
methodology and/or the ESI Handbook and
DVDs. Your comments will be considered
in improving and updating the ESI and its
supporting materials.

Days
Months
Years
Don’t know

1

Familiar

24. How familiar are you with AHRQ’s
activities in surge planning and emergency
preparedness?

Please fill in the amount of time it took to
implement the ESI and check the appropriate
box. For example, if it took 3 years, please
type 3 in the space provided and check the
second box to indicate ‘years.’

1

Very
familiar

22. Are any other materials besides the DVDs
and accompanying handbook used to train
ED staff about the ESI?

1

Yes

2

No

3

Don’t know
STOP.
Thank you for participating in this survey.

What other materials are used to train ED
staff about ESI?



SECTION III. NONUSERS OF ESI
1.

What type of triage system does your ED use every day?
1

2 levels – emergent, non-emergent
3 levels – emergent, urgent, nonurgent
3
4 levels – life threatening, emergent, urgent, nonurgent
4
5 levels – Australasian Triage Scale (ATS) formerly National Triage Scale of Australia –
resuscitation, emergent, urgent, semi-urgent, nonurgent
5
5 levels – Manchester – immediate, very urgent, urgent, standard, nonurgent
6
5 levels – Canadian Triage and Acuity Scale (CTAS) – resuscitation, emergent, urgent,
less urgent, nonurgent
7
5 levels – Other triage system/Don’t know the name of the triage system
8
Other (please specify)
2

9

2.

No triage tool is used in my ED

In this question, we would like to know about the barriers to implementing ESI in your ED. Using
the scale below, please indicate the degree to which each of the listed items may be barriers to
preventing the implementation of the ESI in your ED.
Please rate ALL that apply and select N/A for those that do not apply.
Does not
Prevent

Somewhat
Prevents

5

4

3

Strongly
prevents

N/A

1

0

2

a. Unfamiliar with the ESI
b. Costs associated with training
ED staff

5

4

3

2

1

0

5

4

3

2

1

0

c. Fear of cultural change in the ED

5

4

3

2

1

0

d. Happy with current system

5

4

3

2

1

0

e. ESI offers no value added

5

4

3

2

1

0

f.
g.

h.

i.

j.

k.

5

4

3

2

1

0

5

4

3

2

1

0

5

4

3

2

1

0

5

4

3

2

1

0

5

4

3

2

1

0

5

4

3

2

1

0

ESI is too complicated
Not convinced ESI is a better
method
Not convinced it is worth the effort
to change to ESI
Afraid that there will not be
widespread acceptance of ESI
among ED staff
The hospital or ED is addressing
other important priorities
Other (please specify):



3.

4.

Did you receive the ESI training materials?
1

Yes

2

No

8.

Please indicate whether you have reviewed
the ESI training materials by selecting ONE
of the following responses.
Reviewed only the ESI handbook
Reviewed only the ESI DVDs
3
Reviewed both the ESI handbook
and DVDs
4
Did not review either the ESI handbook
or ESI DVDs

How familiar are you with AHRQ’s
activities in surge planning and emergency
preparedness?

Very
familiar

Familiar

A little
familiar

Not really
familiar

Not at all
familiar

N/A

5

4

3

2

1

0

1
2

5.

9.

Is the reason that you did not implement
the ESI in your ED because you felt that
the training materials (ESI Handbook and
DVDs) did not adequately prepare you to
implement the ESI?

This is AHRQ’s first assessment of
the ESI methodology and supporting
materials. AHRQ wants the ESI and
supporting materials to be as helpful as
possible. Please take this opportunity to
provide feedback on any aspect of the ESI
methodology and/or the ESI Handbook and
ESI DVDs or on ED triaging, in general.
Your comments will be considered in
improving and updating the ESI and its
supporting materials.

1

Yes
2
No, the ESI was not implemented
for other reasons
3
The ESI was never under consideration
at my ED
4
Don’t know
6.

Is your organization considering using the
ESI in the future?
1
2

7.

Yes
No

Are you aware of the Agency for
Healthcare Research and Quality (AHRQ)
and its mission?
1
2

STOP.
Thank you for participating in this survey.

Yes
No

10

SECTION IV. ESI REQUESTERS
FROM A NONHOSPITAL SETTING
1.

4.

Please indicate whether you have reviewed
the ESI training materials by selecting ONE
of the following responses.
1

Reviewed only the ESI handbook
Reviewed only the ESI DVDs
3
Reviewed both the ESI handbook
and DVDs
4
Did not review either the ESI handbook
or ESI DVDs

In general, what type of organization do
you work for? (e.g., research, government
agency, medical school, etc)

2

5.

Is your organization considering using the
ESI in the future?
1

2a. Are you aware of the Emergency Severity
Index (ESI) 5-level triage methodology?
1
2

Yes
No  [SKIP TO QUESTION 4]

6.

2
3
4

5
6
7
8
9

3

Don’t know

Are you aware of the Agency for Healthcare
Research and Quality (AHRQ) and its mission?
2

Agency for Healthcare Research and
Quality (AHRQ) website
AHRQ, other than the website
Emergency medical conference
Professional conference other than
for emergency medicine
Used in my ED
Published literature
Medical school coursework
Word of mouth
Other (please specify):

7.

Yes
No

How familiar are you with AHRQ’s activities in
surge planning and emergency preparedness?

Very
familiar

Familiar

A little
familiar

Not really
familiar

Not at all
familiar

N/A

5

4

3

2

1

0

8.

3.

Yes
No

1

2b. How did you first become aware of the ESI?
1

2

This is AHRQ’s first assessment of the ESI
methodology and supporting materials. AHRQ
wants the ESI and supporting materials to
be as helpful as possible. Please take this
opportunity to provide feedback on any
aspect of the ESI methodology and/or the ESI
Handbook and ESI DVDs or on ED triaging, in
general. Your comments will be considered
in improving and updating the ESI and its
supporting materials.

Why did you request the ESI training
materials?

STOP.
Thank you for participating in this survey.
11