Facing ED headwinds, UMass Memorial found relief in triage overhaul

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Worcester, Mass.-based UMass Memorial Health has expanded the use of Mednition’s KATE AI triage support tool to five additional emergency departments after seeing early success at its flagship hospital.

The software, first implemented in February 2023, is designed to help nurses more accurately assign acuity levels on the Emergency Severity Index, which determines the priority of patients needing medical attention.

Traditionally, nurses collect patient data during triage and enter it into the medical record. KATE uses an algorithm to analyze that data — along with the patient’s medical history and other contextual factors — and alerts nurses if a different acuity level may be more appropriate.

Ken Shanahan, MSN, RN, senior director of emergency medicine and behavioral health at UMass Memorial Medical Center, told Becker’s the decision to pilot KATE came out of necessity. The emergency department was facing multiple challenges at once: surges in COVID-19 cases, a local nursing strike, and the launch of a hospital-at-home program that pulled experienced staff from the ED. Compounding those issues was the hospital’s ranking among the lowest in the state for bed-to-population ratio.

“We knew we had to do something different,” Mr. Shanahan said. “We were seeing high left-without-being-seen rates, long wait times in the waiting room and concerns about triage accuracy.”

Given that UMass Memorial operates in a unionized environment, the hospital involved nursing leadership and union representatives early in the process. Initial concerns — particularly fears the AI would be used punitively — were addressed through transparent communication.

“This tool isn’t about catching people doing something wrong,” Mr. Shanahan said. “It’s about supporting nurses in incredibly high-stress, high-risk environments.”

Since implementation, staff support for the tool has grown. Mr. Shanahan said nurses appreciate that KATE is both unobtrusive and helpful.

“It’s like having a second set of eyes,” he said. “And in emergency care, that can be life-saving.”

The tool has also shown measurable clinical and operational benefits. In an internal review, UMass Memorial found that KATE could have flagged sepsis patients an hour earlier than traditional workflows. Year-over-year metrics also show fewer patients leaving the ED without being seen and a decline in triage-related safety incident reports.

One example came on KATE’s first day in use. The tool flagged a triage discrepancy that mirrored a known patient safety issue identified in a recent root cause analysis. The nurse immediately corrected the triage level.

“That moment alone justified the investment,” Mr. Shanahan said. “When you look at it from a risk management perspective, that saves the organization a huge amount of money.”

KATE is now live in seven of UMass Memorial’s emergency departments.

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