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

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

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.

Study Overview

• Status: Completed
• Conditions: Emergencies
• Intervention / Treatment: Other: Self-triage kiosk; Other: Nurse-initiated triage

Detailed Description

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
• Enrollment (Actual): 400
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Arizona
    • Phoenix, Arizona, United States, 85008
      • Maricopa Integrated Health System

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: No older than 16 years (Child, Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

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

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

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

What is the study measuring?

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.

Collaborators and Investigators

• Sponsor: Valleywise Health
• Collaborators: Agency for Healthcare Research and Quality (AHRQ)
• Investigators: Principal Investigator: Madhumita Sinha, MD, MHSM, Valleywise Health

Publications and helpful links

General Publications

• Morrison-Beedy D, Carey MP, Tu X. Accuracy of audio computer-assisted self-interviewing (ACASI) and self-administered questionnaires for the assessment of sexual behavior. AIDS Behav. 2006 Sep;10(5):541-52. doi: 10.1007/s10461-006-9081-y.
• Sinha M, Khor KN, Amresh A, Drachman D, Frechette A. The use of a kiosk-model bilingual self-triage system in the pediatric emergency department. Pediatr Emerg Care. 2014 Jan;30(1):63-8. doi: 10.1097/PEC.0000000000000037.

Study record dates

Study Major Dates

• Study Start: January 1, 2012
• Primary Completion (Actual): April 1, 2012
• Study Completion (Actual): April 1, 2012

Study Registration Dates

• First Submitted: January 13, 2012
• First Submitted That Met QC Criteria: January 23, 2012
• First Posted (Estimate): January 24, 2012

Study Record Updates

• Last Update Posted (Estimate): October 15, 2012
• Last Update Submitted That Met QC Criteria: September 13, 2012
• Last Verified: September 1, 2012

More Information

Terms related to this study

• Keywords: Triage; Automated; Admitting; Pediatric ED
• Additional Relevant MeSH Terms: Pathologic Processes; Disease Attributes; Emergencies
• Other Study ID Numbers: 2009-110; R03HS020235-01A1 (U.S. AHRQ Grant/Contract)