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

Study Overview
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Brief Summary
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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.

Detailed Description
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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.

Official Title
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Assessing Utility of a Kiosk Model Self-Triage System in the Pediatric Emergency Department of A Tertiary Care Teaching Hospital

Conditions
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Emergencies

Intervention / Treatment
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* Other: Nurse-initiated triage
* Other: Self-triage kiosk


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Self-triage kiosk<br>Audio-assisted self-triage kiosk for obtaining medical history and presenting problem(s) | Other: Self-triage kiosk<br>* Audio-assisted self-triage kiosk for obtaining medical history and presenting problem(s)<br>* Other names: automated self-triage;|
| Experimental: Nurse-initiated triage<br>Nurse-initiated triage for obtaining medical history and presenting problem(s) | Other: Nurse-initiated triage<br>* Nurse-assisted triage for obtaining medical history and presenting problem(s)<br>* Other names: standard triage;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Triage Time | The time it takes for the patient to be triaged, compared across the kiosk and nurse-initiated triage conditions. | From beginning of triage to completion of triage. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 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. | 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. | Upon completion of triage. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Triage, Automated, Admitting, Pediatric ED