Decision Support System on Emergency Triage

Study Overview
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Brief Summary
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The objective of this study is to design a computer-based Decision Support System (DSS) using the ESI (Emergency Severity Index) and ATS (Australasian Triage Scale) algorithms, integrate it into the Hospital Information Management System (HIMS), evaluate the effect of the triage management in the emergency department and ensure the continuity of the system.

Detailed Description
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Background: Triage in the emergency department overstrains employees due to patient density, diversity, and time pressure. Aim: The objective of this study is to design a computer-based Decision Support System (DSS) using the ESI (Emergency Severity Index) and ATS (Australasian Triage Scale) algorithms, integrate it into the Hospital Information Management System (HIMS), evaluate the effect of the triage management in the emergency department and ensure the continuity of the system. Study design: This is a quasi-experimental study with a single-group pre-test and post-test design. The study consisted of three stages. Methods: In the first stage, a SQL (Structured Query Language) Script was developed to evaluate the accuracy and duration of pre-and post-DSS triage decisions. In the second stage (pre-test), the accuracy and duration of pre-DSS triage decisions were evaluated. In the second stage, a DSS was prepared with rule-based decision trees method using the ESI and ATS algorithms and was integrated into the HIMS. In the third and last stage (post-test), the effect of the developed Emergency Triage Decision Support System (ETDSS) on triage management was evaluated against the accuracy and duration of triage decisions.

Official Title
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Effect of Computer-based Decision Support System on Emergency Triage Management

Conditions
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Triage, Emergencies, Decision Support Systems

Intervention / Treatment
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* Other: Emergency triage decision support system


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Data of adult patients who applied to the adult emergency department and whose triage record was opened by a triage nurse. Patient data with no probable or definitive diagnosis of COVID-19. Exclusion Criteria: Data of pediatric trauma patients (under 18 years of age) Patient data for which the triage record was opened by non-nursing healthcare professionals Patient data recorded in triage by nurses who did not receive ATKDS, Emergency nurse triage, ESI, ATS training Data of patients who applied with a probable/definite diagnosis of COVID-19 and underwent PCR testing Patient data in the date range when extraordinary changes were made in the adult emergency department patient triage area and evaluation process due to the COVID 19 pandemic and the developed system could not be used (must use the SB COVID Algorithm)
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: Prevention
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Development of triage decision support system<br>This is a quasi-experimental study with a single-group pre-test and post-test design. The study consisted of three stages. In the first stage, a structured Query Language Script was developed to evaluate the accuracy and duration of pre-and post-DSS triage decisions. In the second stage (pre-test), the accuracy and duration of pre-DSS triage decisions were evaluated. In the second stage, a DSS was prepared with rule-based decision trees method using the ESI and ATS algorithms and was integrated into the HIMS. In the third and last stage (post-test), the effect of the developed Emergency Triage Decision Support System on triage management was evaluated against the accuracy and duration of triage decisions. | Other: Emergency triage decision support system<br>* Evaluating the impact of the developed Emergency Triage Decision Support System on triage management<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Emergency Triage Decision Support System triage management was evaluated against the accuracy and duration of triage decisions | The effect of the decision support system on the triage decision accuracy | 8 weeks (triage decision' accuracy in eight-week hospital information management system data) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Emergency Triage Decision Support System | The effect of decision support system on triage decision duration | 8 weeks (triage decision' duration in eight-week hospital information management system data) |