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

Jessica L. Howe, Jennifer L. Reed, Katharine T. Adams, Cara Elsholz, Erin M. Augustine, Andrea T. Cruz, Cynthia Mollen, Michelle L. Pickett, Sara Schmidt, Kristin Stukus, Raj M. Ratwani, Monika K. Goyal*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
Article number206
JournalJournal of Medical Systems
Volume44
Issue number12
DOIs
StatePublished - Dec 2020

Keywords

  • Pediatric emergency medicine
  • Sexually transmitted infections
  • Workflow analysis

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Information Systems
  • Health Informatics
  • Health Information Management

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