Video triage in calls concerning children with fever at an out-of-hours medical helpline: a prospective quality improvement study
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Video triage in calls concerning children with fever at an out-of-hours medical helpline : a prospective quality improvement study. / Gren, Caroline; Hasselager, Asbjoern Boerch; Linderoth, Gitte; Frederiksen, Marianne Sjølin; Folke, Fredrik; Ersbøll, Annette Kjær; Gamst-Jensen, Hejdi; Cortes, Dina.
I: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Bind 31, Nr. 1, 41, 2023.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Video triage in calls concerning children with fever at an out-of-hours medical helpline
T2 - a prospective quality improvement study
AU - Gren, Caroline
AU - Hasselager, Asbjoern Boerch
AU - Linderoth, Gitte
AU - Frederiksen, Marianne Sjølin
AU - Folke, Fredrik
AU - Ersbøll, Annette Kjær
AU - Gamst-Jensen, Hejdi
AU - Cortes, Dina
N1 - Publisher Copyright: © 2023, Norwegian Air Ambulance Foundation.
PY - 2023
Y1 - 2023
N2 - Background: Parents often contact out-of-hours services due to worry concerning febrile children, despite the children rarely being severely ill. As telephone triage of children is challenging, many children are referred to hospital assessment. This study investigated if video triage resulted in more children staying at home. Secondary aims included safety, acceptability and feasibility of this new triage tool. Methods: In this prospective quality improvement study, nurse call-handlers enrolled febrile children aged 3 months-5 years to video or telephone triage (1:1), with follow-up within 48 h after call. The setting was an out-of-hours call-center for non-urgent illness in Copenhagen, Denmark, receiving over 1 million calls annually and predominately staffed by registered nurses. Main outcome measure was difference in number of children assessed at hospital within 8 h after call between video-and telephone triage group. Rates of feasibility, acceptability and safety (death, lasting means, transfer to intensive care unit) were compared between the triage groups. Results: There was no difference in triage outcome (home care vs. hospital referral) or number of patients assessed at hospital between triage groups. However, more video triaged patients received in-hospital treatment, testing and hospitalization. Conclusion: Video triage was feasible to conduct, acceptable to parents and as safe as telephone triage. The study did not show that more children stayed at home after video triage, possibly because the allocation strategy was not upheld, as video triage sometimes was chosen in cases of complex and severe symptoms, and this likely has changed study outcome. Trial registration: Clinicaltrials.gov.: Id NCT04074239. Registered 2019-08-30. https://clinicaltrials.gov/ct2/show/study/NCT04074239
AB - Background: Parents often contact out-of-hours services due to worry concerning febrile children, despite the children rarely being severely ill. As telephone triage of children is challenging, many children are referred to hospital assessment. This study investigated if video triage resulted in more children staying at home. Secondary aims included safety, acceptability and feasibility of this new triage tool. Methods: In this prospective quality improvement study, nurse call-handlers enrolled febrile children aged 3 months-5 years to video or telephone triage (1:1), with follow-up within 48 h after call. The setting was an out-of-hours call-center for non-urgent illness in Copenhagen, Denmark, receiving over 1 million calls annually and predominately staffed by registered nurses. Main outcome measure was difference in number of children assessed at hospital within 8 h after call between video-and telephone triage group. Rates of feasibility, acceptability and safety (death, lasting means, transfer to intensive care unit) were compared between the triage groups. Results: There was no difference in triage outcome (home care vs. hospital referral) or number of patients assessed at hospital between triage groups. However, more video triaged patients received in-hospital treatment, testing and hospitalization. Conclusion: Video triage was feasible to conduct, acceptable to parents and as safe as telephone triage. The study did not show that more children stayed at home after video triage, possibly because the allocation strategy was not upheld, as video triage sometimes was chosen in cases of complex and severe symptoms, and this likely has changed study outcome. Trial registration: Clinicaltrials.gov.: Id NCT04074239. Registered 2019-08-30. https://clinicaltrials.gov/ct2/show/study/NCT04074239
KW - Fever
KW - Parents
KW - Patient participation
KW - Pediatrics
KW - Primary health care
KW - Telemedicine
KW - Telenursing
KW - Triage
U2 - 10.1186/s13049-023-01106-9
DO - 10.1186/s13049-023-01106-9
M3 - Journal article
C2 - 37644510
AN - SCOPUS:85168963032
VL - 31
JO - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
JF - Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
SN - 1757-7241
IS - 1
M1 - 41
ER -
ID: 374527249