Workflow Analysis Driven Recommendations for Integration of Electronically-Enhanced Sexually Transmitted Infection Screening Tools in Pediatric Emergency Departments.

TitleWorkflow Analysis Driven Recommendations for Integration of Electronically-Enhanced Sexually Transmitted Infection Screening Tools in Pediatric Emergency Departments.
Publication TypeJournal Article
Year of Publication2020
AuthorsHowe JL, Reed JL, Adams KT, Elsholz C, Augustine EM, Cruz AT, Mollen C, Pickett ML, Schmidt S, Stukus K, Ratwani RM, Goyal MK
JournalJ Med Syst
Volume44
Issue12
Pagination206
Date Published2020 Nov 10
ISSN1573-689X
KeywordsAdolescent, Child, Emergency Service, Hospital, Humans, Mass Screening, Sexually Transmitted Diseases, Workflow
Abstract

Adolescents are disproportionately affected by sexually transmitted infections (STIs). Failure to diagnose and treat STIs in a timely manner may result in serious sequelae. Adolescents frequently access the emergency department (ED) for care. Although ED-based STI screening is acceptable to both patients and clinicians, understanding how best to implement STI screening processes into the ED clinical workflow without compromising patient safety or efficiency is critical. The objective of this study was to conduct direct observations documenting current workflow processes and tasks during patient visits at six Pediatric Emergency Care Applied Research Network (PECARN) EDs for site-specific integration of STI electronically-enhanced screening processes. Workflow observations were captured via TaskTracker, a time and motion electronic data collection application that allows researchers to categorize general work processes and record multitasking by providing a timestamp of when tasks began and ended. Workflow was captured during 118 patient visits across six PECARN EDs. The average time to initial assessment by the most senior provider was 76 min (range 59-106 min, SD = 43 min). Care teams were consistent across sites, and included attending physicians, advanced practice providers, nurses, registration clerks, technicians, and students. A timeline belt comparison was performed. Across most sites, the most promising implementation of a STI screening tool was in the patient examination room following the initial patient assessment by the nurse.

DOI10.1007/s10916-020-01670-y
Alternate JournalJ Med Syst
PubMed ID33174093
PubMed Central IDPMC8120323
Grant ListR01 HD094213 / HD / NICHD NIH HHS / United States
R01HD094213 / / Eunice Kennedy Shriver National Institute of Child Health and Human Development /