{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T14:18:26Z","timestamp":1783520306574,"version":"3.55.0"},"reference-count":26,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"unspecified","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,6,23]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Single acute care hospital, Royal Victoria Regional Health Centre, located in Ontario, Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Of 73\u2009132 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\u20135, comprised 59.4% and 34.1%, respectively, of all ED patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most 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: \u22120.44\u2009hours, 95%\u2009CI \u22120.84 to \u22120.05 and adjusted PIA: \u22121.22\u2009hours, 95%\u2009CI \u22121.42 to \u22121.01). 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&lt;0.001). Over 95% of surveyed patients reported being satisfied or very satisfied with the MAPP process and their overall ED experience.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MAPP 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-119893","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T13:30:46Z","timestamp":1783517446000},"page":"e119893","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1136","volume":"16","author":[{"given":"Christopher","family":"Zanette","sequence":"first","affiliation":[{"name":"Royal Victoria Regional Health Centre, Barrie, Ontario, Canada"},{"name":"Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon","family":"Ramagnano","sequence":"additional","affiliation":[{"name":"Royal Victoria Regional Health Centre, Barrie, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell","family":"Greene","sequence":"additional","affiliation":[{"name":"Royal Victoria Regional Health Centre, Barrie, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Ramagnano","sequence":"additional","affiliation":[{"name":"Royal Victoria Regional Health Centre, Barrie, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Hunt","sequence":"additional","affiliation":[{"name":"Royal Victoria Regional Health Centre, Barrie, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hardeep","family":"Uppal","sequence":"additional","affiliation":[{"name":"Royal Victoria Regional Health Centre, Barrie, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Cruise","sequence":"additional","affiliation":[{"name":"Royal Victoria Regional Health Centre, Barrie, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greg","family":"Devet","sequence":"additional","affiliation":[{"name":"Collingwood General and Marine Hospital, Collingwood, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"McLean","sequence":"additional","affiliation":[{"name":"Royal Victoria Regional Health Centre, Barrie, Ontario, Canada"},{"name":"Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2836-8037","authenticated-orcid":false,"given":"Giulio","family":"DiDiodato","sequence":"additional","affiliation":[{"name":"Royal Victoria Regional Health Centre, Barrie, Ontario, Canada"},{"name":"Department of Internal Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"2026070806302978000_16.7.e119893.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2008.03.014"},{"key":"2026070806302978000_16.7.e119893.2","doi-asserted-by":"publisher","DOI":"10.1067\/mem.2003.302"},{"key":"2026070806302978000_16.7.e119893.3","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.d2983","article-title":"Association between waiting times and short term mortality and hospital admission after departure from emergency department: population based cohort study from Ontario, Canada","volume":"342","author":"Guttmann","year":"2011","journal-title":"BMJ"},{"key":"2026070806302978000_16.7.e119893.4","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0203316","article-title":"Emergency department crowding: A systematic review of causes, consequences and solutions","volume":"13","author":"Morley","year":"2018","journal-title":"PLoS One"},{"key":"2026070806302978000_16.7.e119893.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2008.00295.x"},{"key":"2026070806302978000_16.7.e119893.6","unstructured":"Office of the Auditor General of Ontario . 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