Pediatric Emergency Care

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Pediatric Emergency Care:
doi: 10.1097/PEC.0000000000000037
IT in the ED

The Use of a Kiosk-Model Bilingual Self-Triage System in the Pediatric Emergency Department

Sinha, Madhumita MD, MHSM*; Khor, Kai-Ning MPH*; Amresh, Ashish PhD; Drachman, David PhD; Frechette, Alan MD*

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Abstract

Background: Streamlining the triage process is the key in improving emergency department (ED) workflow. Our objective was to determine if parents of pediatric ED patients in, low-literacy, inner-city hospital, who used the audio-assisted bilingual (English/Spanish) self-triage kiosk, were able to enter their child’s medical history data using a touch screen panel with greater speed and accuracy than routine nurse-initiated triage.

Methods: Parent/child dyads visiting the pediatric ED for nonurgent conditions (February to April 2012) were randomized prospectively to self-triage kiosk group (n = 200) and standard nurse triage group (n = 200). Both groups underwent routine nurse-initiated triage that included verbal elicitation of basic medical history and manual entry into patients’ electronic medical records.

Results: The kiosk user was a parent in 88.5% of the cases, a patient (range, 11–17 years) in 9.5% of the cases, and a proxy user (sibling or friend) in 2% of the cases. Language choice for kiosk use was equally distributed (English vs Spanish, 50.5% vs 49.5%). The mean (SD) time to enter medical history data by the kiosk group was significantly shorter than the standard nurse triage group (94.38 [38.61] vs 126.72 [62.61] seconds; P < 0.001). Significant inverse relationship was observed between parent education level and kiosk usage time (r = −0.26; P < 0.001). The mean inaccuracies were significantly lower for kiosk group (P < 0.05) in areas of medical, medication and immunization histories, and total discrepancy score.

Conclusions: Kiosk triage enabled users to enter basic medical triage history data quickly and accurately in an ED setting with future potential for its wider use in improving ED workflow efficiency.

© 2014 Lippincott Williams & Wilkins, Inc.

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