Presentation
Measuring Workflow Interface Misalignment in Emergency Department Triage
SessionWednesday Poster Session
DescriptionED triage is increasingly EHR-mediated, yet little is known about how workflow–interface alignment relates to acuity assignment, workload, and usability. To assess the feasibility of quantifying triage documentation alignment using the Workflow Alignment Index (WAI) and explore associations with ESI assignment, expert-rated accuracy, workload, and usability. Direct observations were conducted for 18 ED triage encounters. Documentation task-event sequences were recorded and used to compute WAI by comparing observed task order with the EHR triage form’s left-to-right element order. ESI accuracy was determined by retrospective two-member expert panel consensus. Nurses completed NASA-TLX and the SUS. Across 392 documentation task-events, 15 task returns occurred, clustering in Reason for Visit and Past Medical History. Mean WAI was 0.784 (SD = 0.075). Nurse-assigned ESI matched expert consensus in 14 encounters (77.8%); mis-triage included three under-triaged and one over-triaged case. Logistic models of ESI accuracy were unstable due to few mis-triage events. Ordinal regression showed WAI was associated with documented ESI level (β = 5.41, SE = 2.32, p = 0.021). Workload and usability varied by nurse despite similar accuracy. WAI was feasible and sensitive to variation in triage documentation behavior. Larger studies are needed to validate associations among alignment, workload, and triage outcomes.
Alternate Presenter
Event Type
Poster
TimeWednesday, October 21st5:30pm - 6:30pm PDT
LocationSummit Pavilion
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