Video triage of children with respiratory symptoms at a medical helpline is safe and feasible – a prospective quality improvement study
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Background Young children are among the most frequent patients at medical call centers, even though they are rarely severely ill. Respiratory tract symptoms are among the most prevalent reasons for contact in pediatric calls. Triage of children without visual cues and through second-hand information is perceived as difficult, with risks of over- and under-triage. Objective To study the safety and feasibility of introducing video triage of young children with respiratory symptoms at the medical helpline 1813 (MH1813) in Copenhagen, Denmark, as well as impact on patient outcome. Methods Prospective quality improvement study including 617 patients enrolled to video or standard telephone triage (1:1) from February 2019-March 2020. Data originated from MH1813 patient records, survey responses, and hospital charts. Primary outcome was difference in patients staying at home eight hours after the call. Secondary outcomes weas hospital outcome, feasibility and acceptability. Adverse events (intensive care unit admittance, lasting injuries, death) were registered. Logistic regression was used to test the effect on outcomes. The COVID-19 pandemic shut the study down prematurely. Results In total, 54% of the included patients were video-triaged., and 63% of video triaged patients and 58% of telephone triaged patients were triaged to stay at home, (p = 0.19). Within eight and 24 hours, there was a tendency of fewer video-triaged patients being assessed at hospitals: 39% versus 46% (p = 0.07) and 41% versus 49% (p = 0.07), respectively. At 24 hours after the call, 2.8% of the patients were hospitalized for at least 12 hours. Video triage was highly feasible and acceptable (>90%) and no adverse events were registered. Conclusion Video triage of young children with respiratory symptoms at a medical call center was safe and feasible. Only about 3% of all children needed hospitalization for at least 12 hours. Video triage may optimize hospital referrals and increase health care accessibility.
Originalsprog | Engelsk |
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Artikelnummer | e0284557 |
Tidsskrift | PLOS ONE |
Vol/bind | 18 |
Udgave nummer | 4 |
Antal sider | 13 |
ISSN | 1932-6203 |
DOI | |
Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
The study was funded by the Danish foundation TrygFonden (ID 124362; awarded to ABH; www.tryghed.dk), the Research Foundation at Amager Hvidovre Hospital (no ID; awarded to CG; https://www.hvidovrehospital.dk/forskning/Sider/default.aspx) and the Research Foundation of the Capital Region (A6207; awarded to DC; https://www.regionh.dk/english/research-and-innovation/Pages/default.aspx). The funders had no role in study design, data collection and analysis, decision to publish, or the preparation of the manuscript. The authors wish to thank all nurses participating in the video triage projects, they could not have been accomplished without you. At EMS Copenhagen, the authors would like to thank former Head of Emergency Medical Dispatch Center Marie Baastrup and former CEO Freddy K. Lippert, for seeing the possibilities in our study and allowing us to implement it. Moreover, thanks to Martin Vang Haugaard at EMS Copenhagen for his data support. Thank you to GoodSAM for the usage of their Instant-on-Scene TM platform, and especially Ali Ghorbangholi for swift and competent technical support at all times.
Publisher Copyright:
Copyright: © 2023 Gren et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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