# Health Pods for Automated Triage Improve Efficiency and Satisfaction in Nurses and Patients
## 4 Discussion  
The main scope of the paper was to test and evaluate the impact of an automated triage solution for basic anamnesis and vital sign measurement. For the purpose, in collaboration with a city hospital, it was decided that the test would be carried out only on low-risk codes patients that arrived at the ED on their own and that would execute the following procedures:  
* Self-measurement of vital signs after the standard triage process performed by the dedicated nurse on a panel of 50 subjects to verify the accuracy of the systems in terms of coherency between the manual measures of the clinical personnel of the ED and the system; this verification was carried out with a random selection of cases and reported by the operators of the voluntary service (presence of the company personnel was excluded for prevent any potential conflicts of interest and not to polarize the results) who were also in charge of collecting satisfaction assessments;
* Self-measurement of vital signs in a period of 2 months with the health pod being freely accessible and without supervision of any operators; after the standard triage, the nurse recommended us to carry out our re-evaluation after 30 min and to report any significant changes. At the end of the experimental period, interviews with ED personnel and voluntary personnel were also carried out for the estimation of the impact of the use of the health pod on the service in terms of time reduction in the procedures or service implementation (time for first triage, patient reassessment execution and time). With this methodological approach, the three aspects were analyzed: reliability of the process, satisfaction of patients and personnel and impact of the new technological solution on the ED triage process. Regarding reliability, the health pod measurements clearly matched the nurse-administered readings: a very limited number of outliers is shown, and nurses reported very good accordance between the self-measurements and the same measurements collected during the triage process. The deviations shown--although small, ranging from 3.46% for BT up to 0.48% for BP in procedural errors--suggest areas of improvement for UI design (better visual description and guide throughout the measurement process) to avoid the presence of artifacts (e.g., arm movement or talking while measuring BP, the imperfect positioning of the thermometer for the BT check, and/or the unstable position of the hands or the movement of the fingers during the recording of the ECG lead I to measure HR and RR) for process calibration and optimization to enhance accuracy in vital sign measurements. In relation to satisfaction and impact, the deployment of the automated health pod in the low-intensity ED zone showed considerable benefits for managing non-urgent cases, with direct implications for workload distribution and patient flow. By autonomously handling low-risk patients, the health pod reduced nurse workload, enabling more focus on high-acuity patients and facilitating better resource allocation, particularly during peak hours. Nurses and their coordinator were interviewed at the end of the experimental period to collect data about this impact factor other than their satisfaction. All of the participants reported very high satisfaction for the following two main aspects: (1) the possibility of longer and higher quality assessments for critical cases in relation to the fact that low-risk cases are constantly monitored by the health pod and there is automated alerting when values of vital signs change so that the situation of that patient can be re-evaluated. Reassessment is usually not carried out by nurses due to the lack of time and this is considered a very relevant impact on the physical and mental workload of nurses in the ED. For this reason, the estimated rate for the overall impact on the re-assessment process is 100%, and the estimation of saved time for the process is estimated to be 5 minper patient every 30 min.