Revision of the Canadian Emergency Department Information System (CEDIS) Presenting Complaint List Version 1.1

Abstract

The original Canadian Emergency Department Information System (CEDIS) Presenting Complaint List was published in 2003. It has 161 complaints and is divided into 18 major categories. At the time of its development, there were a number of Canadian emergency departments (EDs) that had implemented partial emergency department information system (EDIS) solutions. Many departments were at the nascent stages of EDIS development. Since then, there has been a proliferation of ED information technology initiatives spearheaded by a national movement to address ED patient flow and efficiency issues. The 9/11 attack, bioterrorism threats, pandemic influenza concerns, and SARS have provided the impetus to develop syndromic surveillance systems that use a presenting complaint list, often derived electronically from a free-text complaint field. The adoption of the CEDIS Presenting Complaint List in various regions and provinces across the country underscores the utility and acceptance of a coded presenting complaint list. As the trend toward the implementation of EDIS progresses, the development of performance indicators has also occurred. This allows the measurement of various aspects of ED care. There is a strong reliance on the Canadian Emergency Department Triage and Acuity Scale (CTAS) in Canadian EDs to help identify the sickest patients in situations of overcrowding and limited manpower. As well, CTAS has become a measurement tool for identifying casemix groups for funding models and for comparing performance across different institutions. There has been a recent trend to marry the presenting complaint with the CTAS levels in order to increase the reliability of triage measurement across sites. The increase in use of the ED presenting complaint for ancillary reporting reflects the importance of having an accurate complaint list that is reliable, easy to use, understandable and still clinically useful for emergency care providers. The paediatric emergency medicine community has evaluated and adopted the idea of using a paediatric version of CTAS. There has also been work done on improving the interrater reliability of triage by introducing a