Kiosk-Model Self-Triage System in the Pediatric Emergency Department

Valleywise Health400 enrolled

Overview

An audio-assisted self-triage kiosk in the Pediatric Emergency Department (ED) is expected to significantly reduce triage times, without any sacrifice of the quality of information that would be obtained by nurse-initiated triage.

With the rapid evolution of consumer based information technology patients have the opportunity to become collaborative partners in their care. In addition, by bridging information gaps and improving workflow efficiency, continuity of care is optimized and the potential risk for error is reduced. Triage time for kiosk self-triage and nurse-initiated triage will be compared in terms of 1) triage time; 2) accuracy of medical history obtained; and 3) patient satisfaction.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Enrollment

400

Conditions

Emergencies

Interventions

Nurse-initiated triageOTHER

Nurse-assisted triage for obtaining medical history and presenting problem(s)

Self-triage kioskOTHER

Audio-assisted self-triage kiosk for obtaining medical history and presenting problem(s)

Eligibility

Sex: ALLMax age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Between 0 and 18 years of age * Registered in the Pediatric ED * Accompanied by parent/guardian 18 years or older * Version 3 Emergency Severity Index (ESI) of 3 to 5 * Parent or guardian able to communicate in English or Spanish Exclusion Criteria: * Deemed medically unstable * ESI score of 1 or 2 * Incarcerated or in juvenile detention * Parent/guardian unable to communicate in English or Spanish

Locations (1)

Maricopa Integrated Health System

Phoenix, Arizona, United States

Outcomes

Primary Outcomes

Triage Time

The time it takes for the patient to be triaged, compared across the kiosk and nurse-initiated triage conditions.

Time frame: From beginning of triage to completion of triage.

Secondary Outcomes

Accuracy of Medical History

To check for accuracy of medical history information, two RAs approached enrolled parents during the course of their ED visit in the individual patient examination rooms. The RAs conducted a brief face-to-face interview with parents and verified information from the nursing triage summary sheet (for non-kiosk users) and the printout of history sheet from the kiosk users, noting any discrepancies on a Discrepancy Rating Scale. All historical discrepancies were categorized into three groups: major discrepancy, minor discrepancy and no discrepancy.

Time frame: Upon completion of triage.

Patient Satisfaction

Custom survey with 4 items capturing satisfaction with Understanding, Ease of Answering Questions, Respect for Privacy, and Overall Feelings. For each item, the lowest possible score was 1 and the highest possible score was 6. For Understanding, the lowest actual score was 2 and the highest actual score was 6. For Ease of Answering Questions, the lowest actual score was 2 and the highest actual score was 6. For Respect for Privacy the lowest actual score was 3 and the highest actual score was 6. For Overall Feelings, the lowest actual score was 3 and the highest actual score was 6. For the (unweighted) average of all 4 items, the lowest possible score was 1 and the highest possible score was 6. The lowest actual score was 3.5 and the highest actual score was 6.0.

Time frame: Upon completion of triage.

Data from ClinicalTrials.gov

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