Implementation of a Game-based Information System and e-Therapeutic Platform in a Pediatric Emergency Department Waiting Room: Preliminary Evidence of Benefit

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 trialwas 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.