title: The use of a kiosk-model bilingual self-triage system in the pediatric emergency department.
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.
authors.affiliation: From the *Department of Pediatrics, Arizona Children's Center, Maricopa Integrated Health Systems, Phoenix; †College of Technology and Innovation, Arizona State University, Tempe; and ‡Department of Research, Maricopa Integrated Health Systems, Phoenix, AZ.
authors.forename: Madhumita
authors.initials: M
authors.lastname: Sinha
authors.forename: Kai-Ning
authors.initials: KN
authors.lastname: Khor
authors.forename: Ashish
authors.initials: A
authors.lastname: Amresh
authors.forename: David
authors.initials: D
authors.lastname: Drachman
authors.forename: Alan
authors.initials: A
authors.lastname: Frechette
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017598:Efficiency, Organizational / Q000592:standards*; D057286:Electronic Health Records / Q000600:supply & distribution*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000458:organization & administration*; D008297:Male; D008505:Medical Staff, Hospital / Q000458:organization & administration*; D010343:Patient Admission / Q000706:statistics & numerical data*; D011446:Prospective Studies; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014177:Translations; D014218:Triage / Q000458:organization & administration*; D014947:Wounds and Injuries / Q000175:diagnosis