739 - Novel Admission Triage Curriculum for Pediatric Residents

Publication Number: 3715.739

Ashley M. Jimenez Valentin, Stony Brook Children's Hospital, Farmingville, NY, United States; David C. Yang, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States; Rachel Boykan, Renaissance School of Medicine at Stony Brook University, Port Jefferson, NY, United States; Lisa Wilks-Gallo, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States; wei-Hsin Lu, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, United States; Maribeth Chitkara, Stony Brook Children's Hospital, Stony Brook, NY, United States

Background: The Accreditation Council on Graduate Medical Education has standards regarding pediatric residents' ability to coordinate care across the health care continuum and facilitate transfers of care with seamless transitions. Triage of patients requiring inpatient admission is a skill that requires training and deliberate practice.

Objective: 1. Design and pilot an admission triage curriculum (ATC) for the pediatric senior resident night rotation.
2. Evaluate impact of curriculum on resident autonomy and satisfaction, faculty satisfaction, and patient safety.

Design/Methods: We created an ATC for pediatric residents using four common scenarios during admission triage. Residents were invited to attend a live workshop and/or review workshop materials prior to their night senior rotation. Upon starting the rotation, hospital medicine faculty directly observed triage of two admission calls from the emergency department to assess resident readiness to begin independent admission triage (Figure 1).

Surveys were administered to participants prior to workshop participation and/or review of curricular materials (T1), as well as upon completion of their night senior resident rotation (T2). Supervising faculty completed a 9-item survey to assess comfort with resident triage decision-making and plan, both pre- and post-implementation. PICU transfers, rapid response codes and safety reports within 6 hours of admission were reviewed.

Results: 36 residents participated from June 2024 to June 2025. 12 attended the live workshop; 24 reviewed materials independently. 31 surveys were completed at T1 and 15 at T2. 100% of respondents reported improved confidence and perception of autonomy at T2 (Table 1). Tables 2/3 highlight improvements in deferred triage calls and need for faculty feedback regarding admission plans.
14 attending physicians in pediatric hospital medicine, critical care, and emergency medicine completed surveys at 2 time periods (pre- and post-). Qualitative analysis of open-ended responses indicated a high level of comfort with resident admission triage, particularly with "bread and butter" cases.
32 rapid response codes, 15 escalations to PICU and weekly safety reports were reviewed by investigators. No safety concerns were attributable this curriculum.

Conclusion(s): Implementation of the new ATC resulted in a streamlined, safe, and effective admission process that bolstered resident autonomy and confidence during their night senior rotations. Future area of study would include the impact of additional clinical experience on their perceptions of autonomy and confidence.

Admission Triage Curriculum Tables
Admission Triage Curriculum Tables 1-3

Admission Triage Curriculum Process Map
Admission Triage Curriculum Process Map