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Pediatric non-urgent emergency visits

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https://www.readbyqxmd.com/read/29061326/walk-in-model-for-ill-care-in-an-urban-academic-pediatric-clinic
#1
Stephen Warrick, John Morehous, Zeina M Samaan, Mona Mansour, Tracy Huentelman, Pamela J Schoettker, Srikant Iyer
OBJECTIVES: Since the Institute of Medicine's 2001 charge to reform healthcare, there has been a focus on the role of the medical home. Access to care in the proper setting and at the proper time is central to healthcare reform. We aimed to increase the volume of patients receiving care for acute illnesses within the medical home rather than the emergency department or urgent care center from 41% to 60%. METHODS: We used quality improvement methods to create a separate non-emergency care stream in a large academic primary care clinic serving 19,000 patients (> 90% Medicaid)...
October 20, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/28964298/implementation-of-a-perioperative-surgical-home-protocol-for-pediatric-patients-presenting-for-adenoidectomy
#2
Vidya T Raman, Dmitry Tumin, Joshua Uffman, Arlyne K Thung, Candice Burrier, Kris R Jatana, Charles Elmaraghy, Joseph D Tobias
INTRODUCTION: The perioperative surgical home (PSH) is a patient-centered model designed to improve health, streamline the delivery of health care, and reduce the cost of care. Following the national introduction of PSH in 2014 by the ASA, adult hospitals have reported success with this model, with studies validating the benefits of PSH including reducing length of stay, lowering costs, and improving patient satisfaction. METHODS: Eligible patients, ranging in age from 16-35 months of age, were identified by the pre-admission testing (PAT) registered nurses (RNs) and faculty anesthesiologists upon review of the patient history...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28960043/the-clinical-differences-between-urgent-visits-and-non-urgent-visits-in-emergency-department-during-the-neonatal-period
#3
Hyung Jun Yang, Woochan Jeon, Hee Jung Yang, Jae Ryoung Kwak, Hyo Yeon Seo, Ji Sook Lee
As neonates are brought to the emergency department (ED) for various complaints, it is challenging for emergency physicians to clinically determine the urgency of the visit. We sought to explore clinical characteristics associated with urgent visits to the ED. We conducted a retrospective study by reviewing medical records of neonatal visits to a tertiary pediatric regional emergency center for 5 years. Cases of patients who were discharged after checking only chest or abdominal X-ray or discharged without workup, were classified as non-urgent visits...
November 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28875599/the-impact-of-middle-east-respiratory-syndrome-outbreak-on-trends-in-emergency-department-utilization-patterns
#4
So Hyun Paek, Do Kyun Kim, Jin Hee Lee, Young Ho Kwak
Changes occurred in the patterns of utilization of emergency medical services during the Middle East respiratory syndrome (MERS) outbreak. The purpose of this study was to analyze the patterns of adult and pediatric patients who visited the emergency department (ED) during the outbreak. This retrospective study was conducted by analyzing changes in the patterns of visits among adult and pediatric patients in the ED at one tertiary teaching hospital in Korea. The study was performed from June 1, 2013 to July 31, 2015...
October 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28845042/factors-determining-parents-decisions-to-bring-their-children-to-the-pediatric-emergency-department-for-a-minor-illness
#5
Sigita Burokienė, Juozas Raistenskis, Emilija Burokaitė, Rimantė Čerkauskienė, Vytautas Usonis
BACKGROUND The number of children visiting Emergency Departments (EDs) is increasing in Lithuania; therefore, the aim of this study was to determine the factors influencing the parental decision to bring their child to the ED for a minor illness that could be managed in a primary healthcare setting, and to compare parents' and medical professionals' attitudes toward a child's health status and need for urgent care. MATERIAL AND METHODS A prospective observational study was performed at the tertiary-level teaching Children's Hospital in Vilnius...
August 28, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28833943/pediatric-emergency-department-utilization-and-reliance-by-insurance-coverage-in-the-united-states
#6
Lauren E Schlichting, Michelle L Rogers, Annie Gjelsvik, James G Linakis, Patrick M Vivier
OBJECTIVES: For many children, the emergency department (ED) serves as the main destination for health care, whether it be for emergent or nonurgent reasons. Through examination of repeat utilization and ED reliance (EDR), in addition to overall ED utilization, we can identify subpopulations dependent on the ED as their primary source of health care. METHODS: Nationally representative data from the 2010 to 2014 Medical Expenditure Panel Survey were used to examine the annual ED utilization of children age 0 to 17 years by insurance coverage...
August 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28717779/impact-of-middle-east-respiratory-syndrome-outbreak-on-the-use-of-emergency-medical-resources-in-febrile-patients
#7
Hyunho Jeong, Sikyoung Jeong, Juseok Oh, Seon Hee Woo, Byung Hak So, Jeong Hee Wee, Ji Hoon Kim, Ji Yong Im, Seung Pill Choi, Kyoungnam Park, Byul Nim Hee Cho, Sungyoup Hong
OBJECTIVE: Outbreaks of transmissible respiratory infection are suspected to have significant effects on the health of pediatric and geriatric patients. The objective was to assess the impact of the Middle East respiratory syndrome (MERS) outbreak on the use of emergency resources. METHODS: An ecologic analysis of emergency department (ED) records between September and December 2015, was performed. Data was obtained from the National Emergency Department Information System database for Korea...
June 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28688994/comparison-of-30-day-emergency-department-bouncebacks-after-pediatric-versus-adult-urologic-surgery
#8
Courtney L Shepard, Julian Wan
INTRODUCTION: More pediatric patients seem to present to the emergency department (ED) for non-urgent matters after urologic procedures than adult patients. Under new and expanding healthcare reform, pediatric urologists may be penalized for these visits. We compare our 30-day postoperative bounceback rates to the ED and the acuity of the concerns in these populations. MATERIALS AND METHODS: All urology consults at our institution are maintained on a prospectively tracked database...
August 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28668199/chronic-respiratory-failure-utilization-of-a-pediatric-specialty-integrated-care-program
#9
Robert J Graham, Michael L McManus, Angie Mae Rodday, Ruth Ann Weidner, Susan K Parsons
OBJECTIVE: Describe utilization and satisfaction in a specialty integrated care program for children with severe, chronic respiratory insufficiency (CRI). SUBJECTS: Enrollees of the Critical Care, Anesthesia, Perioperative Extension (CAPE) and Home Ventilation Program. METHODS: Children with CRI received home visits, care coordination, and "on-demand" 24/7 access to physicians. Program activity and outcomes were recorded for 3 years using an adapted Care Coordination Measurement Tool© version...
March 2017: Healthcare
https://www.readbyqxmd.com/read/28423834/communication-of-children-symptoms-in-emergency-classification-of-the-terminology
#10
Jessica Rochat, Johan Siebert, Annick Galetto, Christian Lovis, Frédéric Ehrler
The significant part of non-urgent visits to the emergency highlight the necessity to advise people on the actions to take according to their symptoms. Although information sources are accessible through different channels their content often employs medical terminologies that are difficult to understand by laypersons. Our goal is to provide a terminology of the most common symptoms in pediatric emergency adapted to laypersons. This terminology is organized in a hierarchy by the mean of a card-sorting study...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28215655/the-caregiver-perspective-on-unscheduled-72-hour-return-visits-to-pediatric-acute-care-sites-a-focus-on-discharge-processes
#11
Nidhya Navanandan, Sarah K Schmidt, Natasha Cabrera, Michael C DiStefano, Rakesh D Mistry
OBJECTIVE: To characterize pediatric caregivers' reasons for 72-hour emergency department (ED) and urgent care (UC) returns. METHODS: A sample of caregivers returning within 72 hours of initial visit to a pediatric ED or affiliated UC site was surveyed from November 2014 to June 2015; patients evaluated at outside ED/UC, scheduled for return, or non-English/Spanish speaking were excluded. Caregiver surveys underwent item generation, validation, and pilot testing...
September 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/27315242/profiling-the-patients-visiting-the-emergency-room-for-musculoskeletal-complaints-characteristics-and-outcomes
#12
Mattia Bellan, Rossella Molinari, Luigi Castello, Daniele Sola, Antonello Gibbin, Giulia Guaschino, Roberta Pedrazzoli, Alessia Puma, Mario Pirisi, Gian Carlo Avanzi, Pier Paolo Sainaghi
Non-traumatic musculoskeletal complaints are often dealt with by emergency room (ER) physicians. We aimed to quantify how many patients with such complaints have conditions requiring immediate recognition and treatment, versus specialist referral, versus primary care. We retrieved the clinical records of all the patients admitted to the ER department of our hospital along 1 year. Pediatric (age <14 years) and obstetrics/gynecology cases were excluded. Data from all patients visiting the ER for non-traumatic musculoskeletal complaints were classified as follows: true emergencies (i...
November 2016: Clinical Rheumatology
https://www.readbyqxmd.com/read/26854207/what-parents-want-does-provider-knowledge-of-written-parental-expectations-improve-satisfaction-in-the-emergency-department
#13
COMMENT
Kathleen S W Zoltowski, Rakesh D Mistry, David C Brousseau, Travis Whitfill, Paul L Aronson
OBJECTIVE: Satisfaction is an important measure of care quality. Interventions to improve satisfaction in the pediatric emergency department (ED) are limited, especially for patients with nonurgent conditions. Our objective was to determine if clinician knowledge of written parental expectations improves parental satisfaction for nonurgent ED visits. METHODS: This randomized controlled trial was conducted in a tertiary-care pediatric ED. Parents of children presenting for nonurgent visits (Emergency Severity Index level 4 or 5) were randomized into 3 groups: 1) the intervention group completed an expectation survey on arrival, which was reviewed by the clinician, 2) the control group completed the expectation survey, which was not reviewed, and 3) the baseline group did not complete an expectation survey...
May 2016: Academic Pediatrics
https://www.readbyqxmd.com/read/25455081/-an-epidemiological-study-of-early-consultations-of-newborns-in-pediatric-emergency-units
#14
P Richier, X Gocko, O Mory, B Trombert-Paviot, H Patural
BACKGROUND: The number of visits to the pediatric emergency services has increased in the past 20 years in France and around the world, especially for neonates (under 28 days of age). OBJECTIVES: Determine for neonates the reasons requiring medical consultation in the emergency pediatric unit of Saint-Etienne University Hospital (France) and isolate the proportion of "non-urgent" preventable consultations that could be managed outside of emergency units. METHOD: Epidemiological, retrospective study on computerized data on neonates who were referred to the pediatric emergency unit of the Saint-Étienne University Hospital from 1 January to 31 December 2011...
February 2015: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/24517964/the-proportion-of-potentially-preventable-emergency-department-visits-by-patients-with-sickle-cell-disease
#15
Mark Nimmer, Raymond G Hoffmann, Mahua Dasgupta, Julie Panepinto, David C Brousseau
BACKGROUND: Emergency department (ED) visits by children with sickle cell disease (SCD) are often classified as urgent based on resource utilization. This classification may not accurately reflect the potentially preventable nature of SCD visits. We sought to determine the proportion of SCD crisis-related pediatric ED visits that are possibly preventable. PROCEDURE: We reviewed 2 years of ED visits with a diagnosis of SCD with crisis at a hospital with an established sickle cell program...
January 2015: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/24219903/clinical-utility-of-screening-laboratory-tests-in-pediatric-psychiatric-patients-presenting-to-the-emergency-department-for-medical-clearance
#16
J Joelle Donofrio, Genevieve Santillanes, Bradley D McCammack, Chun Nok Lam, Michael D Menchine, Amy H Kaji, Ilene A Claudius
STUDY OBJECTIVE: We assess whether screening laboratory tests obtained to medically clear pediatric psychiatric patients altered management or disposition. METHODS: This was a retrospective chart review of consecutive patients younger than 18 years and presenting to an academic pediatric emergency department for medical clearance of an acute psychiatric emergency potentially requiring an involuntary hold (danger to self, danger to others, grave disability) from July 2009 to December 2010...
June 2014: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/23411527/-children-stomatology-outpatient-treatment-requirements-analysis-and-countermeasures
#17
Bin Xia, Man Qin, Ye Han, Sun Zhang
OBJECTIVE: To assess dental treatment needs and oral health status among children under 18-year-old in Beijing and to examine how these are affected by age, gender. METHODS: In the retrospective study, 3 148 children aged 0.8-18.0 years were selected from patients who first visit the Department of Paediatric Dentistry, Peking University School and Hospital of Stomatology, from May 2010 to January 2011. The treatment needs were evaluated and analysed. RESULTS: Mean age of the group was 6...
February 18, 2013: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/21305425/a-reduction-in-emergency-department-use-by-children-from-a-parent-educational-intervention
#18
Stuart J Yoffe, Robert W Moore, John O Gibson, Nemat M Dadfar, Rebecca L McKay, David A McClellan, Tse-Yang Huang
BACKGROUND AND OBJECTIVES: A substantial proportion of emergency department (ED) visits by children are for non-urgent care. The objective of this research is to determine whether a parent-focused educational intervention can reduce non-urgent ED visits. METHODS: A regional hospital system (which includes a central hospital, four satellite hospitals, and two primary care clinics) provided monthly data retrospectively from January 2006 to October 2007 on ED visits by children...
February 2011: Family Medicine
https://www.readbyqxmd.com/read/21283936/-non-urgent-emergency-department-visits-at-a-children-s-hospital
#19
Nicolás F Vinelli, Carla Mannucci, Natalia I Laba, Lorenzo del Vecchio, Andrea Valerio, María I Lago, María M Nieto
INTRODUCTION: The primary function of an Emergency Department is to assist patients with acute conditions; however, many visits are for nonurgent reasons. The objectives of this study were to estimate the prevalence of nonurgent emergency department visits and to describe the reasons for them. POPULATION AND METHODS: Cross-sectional and descriptive study, conducted in a Pediatric Hospital. We included patients aged between 1 month and 18 years, who presented to the emergency department during the whole day, in working and non-working days...
February 2011: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/20973320/accuracy-of-pediatric-triage-at-siriraj-hospital-bangkok-thailand
#20
Worapant Kriengsoontornkij, Busaba Homcheon, Chulathida Chomchai, Wipapen Neamsomboon
BACKGROUND: Siriraj Hospital is a busy 2500-bed hospital located in Bangkok, Thailand It has over 1.7 million outpatients, including 120,000 emergency room visits a year, 20,000 of which are pediatric patients. The Pediatric Triage (Pedtriage) system has been in used since the year 2001, but the factors that affect the performance of triage nurse have not been evaluated. OBJECTIVE: To compare the performance non-pediatric nurses who are responsible for pediatric patients in the emergency room before and after pediatric triage training at Siriraj Hospital...
October 2010: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
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