Abstract
Background: Pain, dehydration and anxiety are often not well managed in the paediatric emergency department (PED) waiting room (WR), particularly when wait times are long. Children who experience better WR care may require fewer diagnostic tests and other interventions downstream in the PED. WR time can present a unique opportunity to engage families in their own management. We developed iCare Adventure, a game based information system and e-therapeutic platform, and implemented it in a tertiary care PED WR. We report the results of our initial benefits evaluation. Research question: Is exposure to iCare Adventure associated with improvements in PED WR care? Methodology: An unblinded controlled clinical trial was performed, with intervention being exposure to iCare Adventure, and control being standard waiting room care. Primary outcome measures: patient-reported pain, patient and parent-reported satisfaction and amount of oral rehydration therapy (ORT) consumed in the WR. Secondary outcomes: physician dwell time and interventions ordered after leaving the WR. Results: Compared to controls, older intervention subjects showed significant improvements in pain control, and both patient and parent satisfaction. Among younger patients, a significant reduction in the ordering of blood work was observed. No differences in ORT or other post-waiting room interventions were seen. Conclusions: iCare Adventure is associated with improvements in pain control and parental/patient satisfaction in the PED WR, and a reduction in blood work ordered subsequently. Future research will focus on understanding the age-related discrepancy in findings, and in further validating these findings.
| Original language | English |
|---|---|
| Pages (from-to) | 332-339 |
| Number of pages | 8 |
| Journal | Procedia Computer Science |
| Volume | 63 |
| DOIs | |
| Publication status | Published - 2015 |
| Event | 6th International Conference on Emerging Ubiquitous Systems and Pervasive Networks, EUSPN 2015 - Berlin, Germany Duration: Sept 27 2015 → Sept 30 2015 |
Bibliographical note
Funding Information:Our team consists of a unique collaboration between a local technology industry partner (Everage Inc) and academic health care, with an arrangement that provides Everage Inc with the intellectual property (IP) rights, uses a tertiary care institution as an industry test bed, and provides the institution involved with an unlimited license and technical support to use the technology once developed. iCare Adventure was developed over a 3 year period with extensive input from emergency physicians, Child Life st aff, nurses, clinical informatics, pain management researchers, and health administrators. Innovation in acute care faces substantial obstacles32; our development model has married industry informed development processes, including Lean and Agile methodologies, to local clinical champions and the rigorous evidence-based benefit analysis required by academic medicine. Further, we have accomplished this with many hours of in-kind work by all involved, but with very low amounts of direct funding. The institutional component is less than $30,000 to date, funded in part by a Translating Research Into Care (TRIC) grant from the IWK Foundation ($18,000) and in part by existing academic funds remaining from other projects. The total cost from our institutional operating budget is measured in hundreds of dollars.
Publisher Copyright:
© 2015 The Authors.
ASJC Scopus Subject Areas
- General Computer Science