Agnihotri Tanya, Fan Mark, McLeod Shelley, Borgundvaag Bjug, Ovens Howard, McCarron Joy, Trbovich Patricia
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
Centre for Research and Innovation, North York General Hospital, Toronto, Ontario, Canada.
Can J Nurs Res. 2021 Jun;53(2):107-113. doi: 10.1177/0844562119893514. Epub 2020 Jan 21.
To qualitatively contrast emergency department triage workflow using a paper-based triage system and an electronic decision-support tool (electronic Canadian Triage and Acuity Scale (eCTAS)).
Triage nurses from a single institution were invited to perform triage assessments of mock patients using a paper-based triage system and eCTAS. These assessments were completed using simulation scenarios, some of which involved facilitators probing triage nurses' thoughts on the design of the eCTAS system. Participants were asked to "think aloud," describing their thought patterns as they completed the triage process. Similar patient scenarios with the same Canadian Emergency Department Information System (CEDIS) presenting complaint and triage score were used for comparison between paper-based triage and electronic decision-support tool (eCTAS) conditions.
Eight participants completed at least two simulation scenarios for each condition and at least one usability scenario with eCTAS. The simulated encounters showed eCTAS provided several advantages to paper-based triage assessment process by shortlisting possible CEDIS complaints and preselecting relevant modifiers. However, usability concerns were identified with eCTAS including challenges related to data entry and eCTAS score overrides.
Our study highlights several positive features of eCTAS and usability issues that should be addressed to enhance the intended use of eCTAS and support user adoption.
使用纸质分诊系统和电子决策支持工具（电子加拿大分诊与 acuity 量表（eCTAS））对急诊科分诊工作流程进行定性对比。
邀请来自单一机构的分诊护士使用纸质分诊系统和 eCTAS 对模拟患者进行分诊评估。这些评估通过模拟场景完成，其中一些场景涉及引导者探究分诊护士对 eCTAS 系统设计的想法。要求参与者“边想边说”，在完成分诊过程时描述他们的思维模式。使用具有相同加拿大急诊科信息系统（CEDIS）主诉和分诊分数的相似患者场景，对纸质分诊和电子决策支持工具（eCTAS）情况进行比较。
八名参与者针对每种情况完成了至少两个模拟场景，并使用 eCTAS 完成了至少一个可用性场景。模拟会诊表明，eCTAS 通过筛选可能的 CEDIS 主诉并预选相关修饰词，为基于纸质的分诊评估过程提供了几个优势。然而，eCTAS 存在可用性问题，包括与数据录入和 eCTAS 分数覆盖相关的挑战。
我们的研究突出了 eCTAS 的几个积极特征以及为增强 eCTAS 的预期用途和支持用户采用而应解决的可用性问题。
