Outcome measures
death
ADVERSE EVENTS, DISEASES, MINOR, ADVERSE EVENT
Outcome data were derived from four sources: MH1813 patient records, questionnaire responses from parents and call-handlers, and the hospitals’ patient charts. The primary outcome of the study was to investigate if video triage could result in 10-percentage points more patients being able to stay at home during the first 8 h after the call. In 2018 56% children were triaged to stay at home. The time frame, the first 8 h after the call, was chosen to decrease the risk of including a natural deterioration that had nothing to do with the call and triage decision when including the patient in the study. If a longer time frame had been chosen, there’s a risk that a natural worsening could be interpreted as a wrongful triage decision at time of inclusion.The patients’ age, gender and triage outcome were retrieved from MH1813 patient records, and reason for contact was retrieved from the call-handlers’ questionnaire. Triage outcome was primarily divided into (1) the patient being advised to stay at home, possibly with contact to GP or MH1813 if necessary, or (2) into hospital referral. It was further registered if the children referred to hospital were referred to a pediatric emergency department (PED) or to a pediatric urgency care clinic (PUCC). This reflects the urgency perceived by the call-handler, as only suspected minor illnesses are to be assessed at PUCCs, where no possibility for treatment or extensive paraclinical testing exists. All included patients were followed-up in the region’s electronic hospital charts up to 48 h after the call. If a patient had been assessed at a hospital, the chart was read to identify time, location, International Statistical Classification of Diseases and Related Health Problems (ICD-10) diagnosis, treatment, and duration of the child’s stay at the hospital. ICD-10 diagnoses were gathered in groups of similar character. Adverse events, defined as transfer to intensive care unit, signs of lasting means or death were also identified in the hospitals’ patient charts. The follow-up was carried out 2–8 days after the call.The parental DOW was investigated before and after calls in the two study groups. It was studied if video triage reduced the parents’ DOW, and if the parental DOW was associated with the child being assessed at a hospital, both in total and in the two separate study groups. It was also investigated if DOW was associated to triage group.Safety was defined as the occurrence of adverse events (death, signs of lasting means or transfer to intensive care unit) and feasibility as the rate of successful video calls, and acceptability as how many parents that consented to participate in video triage.