Caregiver alignment with triage acuity levels and drivers for discrepancy between caregiver assessment and triage acuity levels: a cross-sectional questionnaire based study

Abstract Background Caregiver concern is the main driver to paediatric emergency departments visits. Understanding caregiver worries is crucial to guide patients to the most appropriate healthcare setting. Previous research shows mixed findings on the accordance between caregiver assessment and prof...

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Main Authors: Noelie Lengeler, Carl Alessandro Starvaggi, Manon Jaboyedoff, Sophie Affentranger, Kristina Keitel
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Health Services Research
Subjects:
Online Access:https://doi.org/10.1186/s12913-024-12163-w
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author Noelie Lengeler
Carl Alessandro Starvaggi
Manon Jaboyedoff
Sophie Affentranger
Kristina Keitel
author_facet Noelie Lengeler
Carl Alessandro Starvaggi
Manon Jaboyedoff
Sophie Affentranger
Kristina Keitel
author_sort Noelie Lengeler
collection DOAJ
description Abstract Background Caregiver concern is the main driver to paediatric emergency departments visits. Understanding caregiver worries is crucial to guide patients to the most appropriate healthcare setting. Previous research shows mixed findings on the accordance between caregiver assessment and professional triage. Methods We assessed data from two questionnaire-based studies conducted over 27 months in two tertiary paediatric emergency departments in Switzerland to compare caregiver perception of their child’s medical acuity and standard nurse triage. Furthermore, we examined socioeconomic factors associated with caregiver perception. Results Our study of 2,126 children seen in the two paediatric emergency departments showed that caregiver assessment aligned well with the acuity assigned by professional triage in 89% (1,901/2,126) of cases. In 142 cases (7%, 142/2,126), caregivers rating their child’s severity higher than nurse’s triage while in 83 cases (4%, 83/2,126), they rated it lower. In an univariable analysis, we found that family’s difficulties paying bills (20% vs. 12%) and low maternal education (19% vs. 10%) were associated with a higher percentage of caregiver rating their child’s severity higher than nurse’s triage. Fever as the main complaint was associated with caregiver rating their child’s severity lower than nurse’s triage. Conclusions This questionnaire-based study shows that caregiver’s assessment of the severity of the child and nurse triage are concordant in most situations. Our study sheds light on the association between caregiver assessment and professional triage in two paediatric emergency departments in Switzerland, revealing some of the factors leading to discordance. These factors most probably reflect health illiteracy. It is important that healthcare professionals recognize and address factors influencing caregiver assessments to facilitate accurate decision-making and enhanced paediatric emergency care outcomes.
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spelling doaj-art-1393cc06fe094bb89325ef5b0af0f0722025-02-02T12:14:03ZengBMCBMC Health Services Research1472-69632025-01-012511910.1186/s12913-024-12163-wCaregiver alignment with triage acuity levels and drivers for discrepancy between caregiver assessment and triage acuity levels: a cross-sectional questionnaire based studyNoelie Lengeler0Carl Alessandro Starvaggi1Manon Jaboyedoff2Sophie Affentranger3Kristina Keitel4Division of Paediatric Emergency Medicine, Department of Paediatrics, Inselspital, Bern University HospitalDivision of Paediatric Emergency Medicine, Department of Paediatrics, Inselspital, Bern University HospitalPaediatric Infectious Diseases and Vaccinology Unit, Service of Paediatrics, Department Mother-Woman-Child, Lausanne University Hospital and University of LausanneDivision of Paediatric Emergency Medicine, Department of Paediatrics, Inselspital, Bern University HospitalDepartment of Paediatrics, Children’s National HospitalAbstract Background Caregiver concern is the main driver to paediatric emergency departments visits. Understanding caregiver worries is crucial to guide patients to the most appropriate healthcare setting. Previous research shows mixed findings on the accordance between caregiver assessment and professional triage. Methods We assessed data from two questionnaire-based studies conducted over 27 months in two tertiary paediatric emergency departments in Switzerland to compare caregiver perception of their child’s medical acuity and standard nurse triage. Furthermore, we examined socioeconomic factors associated with caregiver perception. Results Our study of 2,126 children seen in the two paediatric emergency departments showed that caregiver assessment aligned well with the acuity assigned by professional triage in 89% (1,901/2,126) of cases. In 142 cases (7%, 142/2,126), caregivers rating their child’s severity higher than nurse’s triage while in 83 cases (4%, 83/2,126), they rated it lower. In an univariable analysis, we found that family’s difficulties paying bills (20% vs. 12%) and low maternal education (19% vs. 10%) were associated with a higher percentage of caregiver rating their child’s severity higher than nurse’s triage. Fever as the main complaint was associated with caregiver rating their child’s severity lower than nurse’s triage. Conclusions This questionnaire-based study shows that caregiver’s assessment of the severity of the child and nurse triage are concordant in most situations. Our study sheds light on the association between caregiver assessment and professional triage in two paediatric emergency departments in Switzerland, revealing some of the factors leading to discordance. These factors most probably reflect health illiteracy. It is important that healthcare professionals recognize and address factors influencing caregiver assessments to facilitate accurate decision-making and enhanced paediatric emergency care outcomes.https://doi.org/10.1186/s12913-024-12163-wTriagePaediatric emergency medicineCaregiver assessmentSociodemographic factors
spellingShingle Noelie Lengeler
Carl Alessandro Starvaggi
Manon Jaboyedoff
Sophie Affentranger
Kristina Keitel
Caregiver alignment with triage acuity levels and drivers for discrepancy between caregiver assessment and triage acuity levels: a cross-sectional questionnaire based study
BMC Health Services Research
Triage
Paediatric emergency medicine
Caregiver assessment
Sociodemographic factors
title Caregiver alignment with triage acuity levels and drivers for discrepancy between caregiver assessment and triage acuity levels: a cross-sectional questionnaire based study
title_full Caregiver alignment with triage acuity levels and drivers for discrepancy between caregiver assessment and triage acuity levels: a cross-sectional questionnaire based study
title_fullStr Caregiver alignment with triage acuity levels and drivers for discrepancy between caregiver assessment and triage acuity levels: a cross-sectional questionnaire based study
title_full_unstemmed Caregiver alignment with triage acuity levels and drivers for discrepancy between caregiver assessment and triage acuity levels: a cross-sectional questionnaire based study
title_short Caregiver alignment with triage acuity levels and drivers for discrepancy between caregiver assessment and triage acuity levels: a cross-sectional questionnaire based study
title_sort caregiver alignment with triage acuity levels and drivers for discrepancy between caregiver assessment and triage acuity levels a cross sectional questionnaire based study
topic Triage
Paediatric emergency medicine
Caregiver assessment
Sociodemographic factors
url https://doi.org/10.1186/s12913-024-12163-w
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