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

• ClinicalTrials.gov Identifier: NCT01515488
• Recruitment Status: Completed
• First Posted: January 24, 2012
• Results First Posted: October 15, 2012
• Last Update Posted: October 15, 2012
• Sponsor: Valleywise Health
• Collaborator: Agency for Healthcare Research and Quality (AHRQ)
• Information provided by (Responsible Party): Valleywise Health

Study Description

Brief Summary:

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.

Condition or disease	Intervention/treatment	Phase
Emergencies	Other: Nurse-initiated triage; Other: Self-triage kiosk	Not Applicable

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 Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 400 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: None (Open Label)
• Primary Purpose: Health Services Research
• Official Title: Assessing Utility of a "Kiosk Model" Self-Triage System in the Pediatric Emergency Department of A Tertiary Care Teaching Hospital
• Study Start Date: January 2012
• Actual Primary Completion Date: April 2012
• Actual Study Completion Date: April 2012

Arms and Interventions

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 Name: 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 Name: standard triage

Outcome Measures

Primary Outcome Measures :

1. Triage Time [ Time Frame: From beginning of triage to completion of triage. ]
   The time it takes for the patient to be triaged, compared across the kiosk and nurse-initiated triage conditions.

Secondary Outcome Measures :

1. Accuracy of Medical History [ Time Frame: Upon completion of triage. ]
   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.
2. Patient Satisfaction [ Time Frame: Upon completion of triage. ]
   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.

Eligibility Criteria

• Ages Eligible for Study: up to 18 Years (Child, Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

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

Contacts and Locations

Locations

United States, Arizona

Maricopa Integrated Health System

Phoenix, Arizona, United States, 85008

Sponsors and Collaborators

Valleywise Health

Agency for Healthcare Research and Quality (AHRQ)

Investigators

• Principal Investigator: Madhumita Sinha, MD, MHSM; Valleywise Health

More Information

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.

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

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.

• Responsible Party: Valleywise Health
• ClinicalTrials.gov Identifier: NCT01515488
• Other Study ID Numbers: 2009-110; R03HS020235-01A1 ( U.S. AHRQ Grant/Contract )
• First Posted: January 24, 2012
• Results First Posted: October 15, 2012
• Last Update Posted: October 15, 2012
• Last Verified: September 2012

Keywords provided by Valleywise Health:

Triage; Automated; Admitting; Pediatric ED

Additional relevant MeSH terms:

Emergencies; Disease Attributes; Pathologic Processes