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⁎ Corresponding author. precise priority allocations when applied by different emergency nurses. A valid triage system accurately determines the correct priority when applied to varying patient presentations. There are no universal guidelines that can be applied to determine if a triage system’s reliability and validity levels are appropriate within a specific environment. Choosing which triage system to implement within an emergency department therefore comes down to determining how the triage system would perform in that environment against a predetermined set of expected outcomes. Outcomes such as therapeutic interventions, resource utilisation, length of stay and admissions are commonly balanced against the performance measures of a triage system to determine the best balance between resources, safety, efficiency and quality for that specific setting. These outcome measures are inherently subjective goals set to control the movement of patients through a facility, such as a hospital or a clinic, starting at the emergency department. It is most important for any triage system to recognise and determine patient acuity along these predetermined goals and balances so that appropriate resources can be allocated within a reasonable timeframe.

Although the reliability and validity of certain triage systems in particular settings have been established, triage strategies and decision-making remains complex processes that are not well understood. These become more apparent within unestablished environments such as the low-and middle-income settings. The triage decision-making process is dependent on the knowledge and experience of …