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Published on: September 4, 2019
Revealing triage behaviour patterns in ER using a new technology for handwritten data acquisition.
Christelle Despont-Gros1, Gilles Cohen, Olivier T Rutschmann
1Service of Medical Informatics, University of Geneva and University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, CH-1211, Geneva 4, Switzerland.
International Journal of Medical Informatics
|May 9, 2009
Summary
Digital pen and paper technology captured emergency room (ER) triage data, revealing significant variability in form completion and low use of vital signs. This informed a redesigned triage form to improve data acquisition and objective measurements.
Area of Science:
- Clinical Informatics
- Human-Computer Interaction
- Healthcare Process Analysis
Background:
- Data acquisition in high-cognitive workload clinical settings like emergency rooms (ER) presents significant challenges.
- Traditional pen-and-paper methods lack traceability and are prone to observational bias.
- Digital Pen and Paper (DPP) technology offers a natural mechanism to minimize bias and external influences during data capture.
Purpose of the Study:
- To evaluate the utility of DPP technology for capturing ER triage information.
- To analyze how ER triage nurses utilize triage forms under real working conditions.
- To determine if DPP-recorded data can explain variations in triage processes.
Main Methods:
- Analysis of detailed log data from DPP during triage form completion.
- Construction of process representations based on DPP data.
- Supplementation of quantitative data with qualitative, ethnographical-like observations.
Main Results:
- 1183 triage forms were recorded over seven days, with 906 deemed valid.
- The median triage process duration was 143 seconds.
- High variability in form field completion sequence was observed, with vital signs recorded in less than 17% of cases.
Conclusions:
- DPP technology provides an unbiased method for studying data acquisition processes and generating time-series activity data.
- DPP data alone cannot capture contextual information, necessitating complementary qualitative approaches.
- The study led to a redesigned ER triage form to enhance objective measurements and streamline data acquisition.