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<p><strong>You Are Here:</strong> <span class="crumb_link"><a href="/" class="crumb_link">AHRQ Home</a> > <a href="/qual/" class="crumb_link">Quality Assessment</a> > <a href="/qual/measurix.htm" class="crumb_link">Measuring Healthcare Quality</a> > <a href="." class="crumb_link">Emergency Severity Index, Version 4</a> > Note from the Director</span></p>
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<td height="30px"><span class="title"><a name="h1" id="h1"></a>Emergency Severity Index, Version 4: Implementation Handbook</span>
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<h2>Note from the Director</h2>
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<p>The Agency for Healthcare Research and Quality is pleased to bring you the <em>Emergency Severity Index, Version 4: Implementation Handbook</em>. This manual covers all details of the Emergency Severity Index (ESI)—a five-level emergency department triage algorithm that provides clinically relevant stratification of patients into five groups from 1 (most urgent) to 5 (least urgent) on the basis of acuity and resource needs.</p>
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<p>After emergency physicians Richard Wuerz and David Eitel developed the ESI in 1998 and
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pilot testing yielded favorable results, the ESI Triage Group was formed. Further work on the
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initial development of ESI was carried out under an AHRQ grant. The ESI Triage Group, which
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consisted of medical clinicians, managers, educators, and researchers, further refined the
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algorithm to what it is today.</p>
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<p>In keeping with our mission to improve the quality, safety, efficiency, and effectiveness of health care for all Americans, one of AHRQ's areas of emphasis is training. Along with the
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accompanying set of two DVDs, this handbook will provide invaluable assistance to emergency department nurses, physicians, and administrators in the implementation of a comprehensive ESI educational program. These materials are based on ESI Version 4, which updates the algorithm with a particular emphasis on the expansion of ESI level 1 criteria and refinement of the pediatric fever criteria.</p>
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<p>A well-implemented ESI program will help hospital emergency departments rapidly identify
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patients in need of immediate attention, better identify patients who could safely and more
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efficiently be seen in a fast-track or urgent care center rather than the main ED, and more
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accurately determine thresholds for diversion of ambulance patients from the ED.</p>
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<p>We hope that you find this tool useful in your ongoing efforts to improve the quality of care provided by your emergency department.</p>
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<p>Carolyn M. Clancy, M.D.<br />
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Director<br />
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Agency for Healthcare Research and Quality</p>
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<p class="size2"><a href="esi1.htm#Contents">Return to Contents</a><br />
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<a href="esipref.htm">Proceed to Next Section</a></p>
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<p> </p>
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<p> The information on this page is archived and provided for reference purposes only.</p></div>
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