Evidence map›Paper›PMID 42419898›Full record

ArticleBMJ open2026

Does a novel digital self-triage and scheduling pathway reduce wait times for low-acuity emergency department visits in a Canadian community hospital? A prospective cohort study.

Christopher Zanette, Sharon Ramagnano, Mitchell Greene, Lucas Ramagnano, Sydney Hunt, Hardeep Uppal, Kelly Cruise, Greg Devet, Jesse McLean, Giulio DiDiodato

Abstract read
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Christopher ZanetteRoyal Victoria Regional Health Centre, Barrie, Ontario, Canada.
Sharon RamagnanoRoyal Victoria Regional Health Centre, Barrie, Ontario, Canada.
Mitchell GreeneRoyal Victoria Regional Health Centre, Barrie, Ontario, Canada.
Lucas RamagnanoRoyal Victoria Regional Health Centre, Barrie, Ontario, Canada.
Sydney HuntRoyal Victoria Regional Health Centre, Barrie, Ontario, Canada.
Hardeep UppalRoyal Victoria Regional Health Centre, Barrie, Ontario, Canada.
Kelly CruiseRoyal Victoria Regional Health Centre, Barrie, Ontario, Canada.
Greg DevetCollingwood General and Marine Hospital, Collingwood, Ontario, Canada.
Jesse McLeanRoyal Victoria Regional Health Centre, Barrie, Ontario, Canada.
Giulio DiDiodatoRoyal Victoria Regional Health Centre, Barrie, Ontario, Canada didiodatog@rvh.on.ca.ORCID http://orcid.org/0000-0003-2836-8037

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe objectives were to evaluate if a novel self-triaging and self-scheduling emergency department (ED) service, the Minor Ailment Patient Pathway (MAPP), can safely reduce ED wait times for low-acuity patients presenting with either cold and influenza or musculoskeletal ailments.

designProspective cohort study including all consecutive ED patients from 1 June 2023 to 31 March 2024. Outcomes for MAPP patients were compared with contemporaneous, matched ED patients who followed the usual care (UC) ED intake and evaluation process.

settingSingle acute care hospital, Royal Victoria Regional Health Centre, located in Ontario, Canada.

participantsOf 73 132 ED visits during the study period, 2766 (3.8%) used the MAPP. Low-acuity patients, defined by the Canadian Triage and Acuity Scale (CTAS) 3 or 4-5, comprised 59.4% and 34.1%, respectively, of all ED patients.

resultsMost MAPP visits were for cold and influenza symptoms (63.6%) or musculoskeletal ailments (18.4%). Compared with CTAS-matched UC patients, MAPP users had a shorter mean length of stay (LOS) and faster mean physician initial assessment (PIA) time (adjusted LOS: -0.44 hours, 95% CI -0.84 to -0.05 and adjusted PIA: -1.22 hours, 95% CI -1.42 to -1.01). 7-day return visits occurred in 3.2% of MAPP patients compared with 4.4% of UC patients (p=0.002), with fewer admissions on return (1.8% vs 13.2%; p<0.001). Over 95% of surveyed patients reported being satisfied or very satisfied with the MAPP process and their overall ED experience.

conclusionsMAPP was associated with shorter LOS, faster PIA, lower rates of return visits and hospital admissions, and high patient satisfaction, all suggestive of a safe, efficient and patient-centred ED service. Despite these benefits, MAPP was underused with only 9.3% of all cold and influenza and musculoskeletal ED patients self-triaging and self-scheduling an ED MAPP visit during this cohort period.

Indexed as

Appointments and SchedulesEmergency Service, HospitalTriageAdultAgedEmergency Room VisitsFemaleHumansInfluenza, HumanLength of StayMaleMiddle AgedOntarioProspective StudiesWaiting ListsEmergency Service, HospitalHealth Impact AssessmentHealth Services AccessibilityOrganisation of health servicesQuality in health care

Identifiers

PMID42419898
PMCPMC13347828

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.