# Health Pods for Automated Triage Improve Efficiency and Satisfaction in Nurses and Patients
## 1 Introduction  
Hospitals are complex systems requiring integrated and efficient organization of both inter and intra-departments to provide the best possible care for patients. One of the main entry points to the hospital is the emergency department (ED), which has great importance, but it also faces relevant challenges that can hamper the overall flow of the hospital, have an impact on personnel performance and wellbeing, and can affect the quality of care for patients [1]. In recent years, during and after the pandemic period, different factors emerged that affect the safe and efficient operation in EDs: in particular, staffing shortages, limited capacity to manage accessed patients, and performance of ancillary services can lead to an increased risk of medical errors together with longer wait times, resulting overall in a lower quality of care [2, 3]. These critical elements constitute the ED situation: usually, this department is one of the busiest areas of the hospital, experiencing spikes in patient volume, which can strain staff resources. In this context, two of the major problems within hospital emergency rooms are crowding and management of continuous reassessments of waiting patients [4]. Although foreseen by guidelines that mandate regular reassessment to monitor condition changes, this process is often depriitized due to limited available personnel, who are frequently diverted to manage high-risk, complex cases. This gap in care creates a cycle where low-risk patients may experience delayed evaluations, increasing the occurrence of undetected health deterioration and leading to potential complications. Additionally, ED overcrowding impacts both patient and staff satisfaction, as prolonged wait times and inconsistent reassessments reduce at the same time the service efficiency and the patient trust in the care process [4; 5; 6; 7]. The persistent overcrowding in EDs is driven by a combination of factors: an aging population, rising rates of chronic illnesses, and limited inpatient bed availability, which restricts patient throughput and extends ED stays. These conditions strain healthcare resources and further increase wait times, as staff struggle to meet the needs of a growing patient volume while also attempting to maintain high standards of care [6]. This issue has made it imperative for healthcare providers to explore innovative solutions that address both operational efficiency and patient care quality. One promising response to these challenges is the use of automated solutions like health pods: they are self-contained, autonomous stations equipped with medical devices capable of autonomously monitoring vital signs. Health pods--like the CAPSULA Health Pod here tested--offer a novel approach by automating the measurement of vital parameters, allowing low-risk patients to be monitored independently from direct nurse supervision [8]. This automation can facilitate triage operations and reduce the workload on ED personnel, enabling them to prioritize high-acuity cases without compromising the safety of other patients waiting in the ED [8; 9]. In this case, telemedicine systems are not applicable because health pods are an in-person setting with possible urgent intervention. Other possible solutions can be represented by mobile apps, but these digital solutions lack certification as medical devices, which is an essential requirement and do not integrate the necessary measurement of the vital signs through specific biomedical devices. This study presents the first pilot test of a health pod, certified as a biomedical device and registered by the Italian Ministry of Health with the specific intended purpose, that is implemented in the waiting area of a busy urban ED. By autonomously managing access and measurement of vital signs for patients categorized as low risk during the triage process, the CAPSULA Health Pod aims to reduce triage time and to allow a continuous reassessment process, thus alleviating some of the bottlenecks associated with ED overcrowding.