Penerapan Emergency Severity Index untuk Meningkatkan Akurasi Triase di IGD RSUD Kaimana: Application of The Emergency Severity Index to Improve Triage Accuracy in The Emergency Department  of Kaimana Regional Hospital

Hubertina Vera Letsoin; Atik Setiawan W.

Authors

Hubertina Vera Letsoin Universitas Strada Indonesia
Atik Setiawan W. Universitas Strada Indonesia

Keywords:

akurasi klasifikasi, emergency severity index, IGD, keselamatan pasien, triase

Abstract

Abstrak: Pelaksanaan triase di Instalasi Gawat Darurat (IGD) RSUD Kaimana sebelum penerapan Emergency Severity Index (ESI) masih dilakukan secara konvensional tanpa standar baku. Hal ini menyebabkan ketidaktepatan klasifikasi seperti overtriage dan undertriage, yang berdampak pada keterlambatan penanganan dan menurunnya mutu pelayanan kegawatdaruratan. Kegiatan pengabdian masyarakat ini bertujuan meningkatkan akurasi triase, kecepatan penanganan, serta keterampilan tenaga kesehatan IGD melalui penerapan sistem ESI. Metode pelaksanaan meliputi sosialisasi, pelatihan, simulasi klinis, serta pendampingan implementasi langsung di IGD. Evaluasi dilakukan menggunakan pre-test dan post-test, observasi proses triase, dan analisis perbandingan sebelum serta sesudah intervensi. Hasil kegiatan menunjukkan peningkatan akurasi klasifikasi pasien dari 70% menjadi 90%, penurunan overtriage dari 15% menjadi 7%, dan penurunan undertriage dari 10% menjadi 3%. Waktu tanggap pasien prioritas tinggi juga mengalami peningkatan signifikan dari 10 menit menjadi 5 menit. Penerapan sistem triase berbasis ESI terbukti efektif meningkatkan mutu pelayanan, keselamatan pasien, dan profesionalisme tenaga kesehatan di IGD RSUD Kaimana.

Abstract: The triage process in the Emergency Department of Kaimana Regional Hospital was previously performed using a conventional, non-standardized approach, resulting in inaccurate classifications such as overtriage and undertriage. These issues contributed to delays in treatment and reduced the overall quality of emergency care services. This community service program aimed to improve triage accuracy, response time, and the competency of emergency department healthcare workers through the implementation of the Emergency Severity Index (ESI). The methods included socialization, training sessions, clinical simulations, and supervised implementation of ESI in the emergency department. Evaluation was conducted using pre- and post-tests, observation of triage procedures, and comparison analyses before and after the intervention. The results demonstrated an increase in classification accuracy from 70% to 90%, a reduction in overtriage from 15% to 7%, and a decrease in undertriage from 10% to 3%. Additionally, response time for high-priority patients improved significantly from 10 minutes to 5 minutes. The implementation of ESI proved effective in enhancing service quality, patient safety, and the professionalism of healthcare workers in the Emergency Department of Kaimana Regional Hospital.

References

Agency for Healthcare Research and Quality. (2020). Emergency Severity Index (ESI): A triage tool for emergency department care (Version 4). U.S. Department of Health and Human Services.

American College of Emergency Physicians. (2022).Clinical policy for the evaluation and management of emergency department triage. Annals of Emergency Medicine, 79(3), 254–266.https://doi.org/10.1016/j.annemergmed.2021.12.005

Gilboy, N., Tanabe, P., Travers, D. A., & Rosenau, A. M. (2020).Emergency Severity Index (ESI): A triage tool for emergency department care (Version 4). Agency for Healthcare Research and Quality.

Gilboy, N., Tanabe, P., Travers, D. A., & Rosenau, A. M. (2020).Emergency Severity Index (ESI): Implementation handbook (4th ed.). Agency for Healthcare Research and Quality.

Hinson, J. S., Martinez, D. A., Cabral, S., George, K., Whalen, M., Hansoti, B., & Levin, S. (2019).Triage performance in emergency medicine: A systematic review. Annals of Emergency Medicine, 74(1), 140–152.https://doi.org/10.1016/j.annemergmed.2018.09.022

Iskandar, M., & Kurniawan, D. (2021).Hubungan tingkat kompetensi perawat dengan akurasi triase di IGD. Jurnal Keperawatan Darurat, 9(2), 115–122.

Kementerian Kesehatan Republik Indonesia. (2016).Pedoman pelayanan gawat darurat di rumah sakit. Kementerian Kesehatan RI.

Lim, C. S., Yahaya, R., & Mohd Noor, N. (2020).Validity and reliability of the Emergency Severity Index triage system in emergency departments. International Journal of Emergency Medicine, 13(1), 1–7.https://doi.org/10.1186/s12245-020-00276-5

Müller, M., Carter, A., & McCabe, J. (2021).The effectiveness of the Emergency Severity Index triage system in reducing emergency department crowding. International Emergency Nursing, 56, 101047.https://doi.org/10.1016/j.ienj.2021.101047

Putri, R. A., Suryani, M., & Hidayat, R. (2022).Penerapan sistem triase Emergency Severity Index terhadap response time pelayanan di Instalasi Gawat Darurat. Jurnal Keperawatan dan Pelayanan Kesehatan, 10(1), 45–53.

Rahmawati, S., Yuliani, D., & Pranata, R. (2022).Analisis hubungan akurasi triase dengan keselamatan pasien di IGD rumah sakit tipe B. Jurnal Keperawatan Klinis, 10(3), 211–218.

Salway, R. J., Valenzuela, R., Shoenberger, J. M., Mallon, W. K., & Viccellio, A. (2021). Emergency department overcrowding: Evidence-based answers to frequently asked questions. Revista Médica Clínica Las Condes, 32(1), 80–89. https://doi.org/10.1016/j.rmclc.2020.12.002

Utami, D., & Nurdin, A. (2021). Hubungan penerapan Emergency Severity Index dengan efisiensi waktu tunggu dan akurasi triase di Instalasi Gawat Darurat. Jurnal Keperawatan Klinis Indonesia, 5(2), 87–95.

Widodo, T., Nugroho, S., & Lestari, A. (2022).Implementasi triase berbasis ESI untuk menurunkan waktu tanggap IGD: Studi quasi-eksperimen. Jurnal Manajemen Pelayanan Kesehatan, 25(1), 33–41.

World Health Organization. (2021). Emergency care systems for universal health coverage: Ensuring timely care for the acutely ill and injured. World Health Organization.

World Health Organization. (2021).Emergency care system framework: Emergency care system assessment tool. World Health Organization.

Yunita, E., Wardani, D., & Prasetyo, A. (2022).Faktor-faktor yang memengaruhi ketepatan triase di Instalasi Gawat Darurat rumah sakit daerah. Jurnal Manajemen Pelayanan Kesehatan, 25(3), 129–137.