Children in emergency departments: who should provide their care?

Prentiss, Kimball A.; Vinci, Robert J.

doi:10.1136/adc.2008.137885

Cited by 9 publications

(6 citation statements)

References 37 publications

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“…[3][4][5][6][7] Internationally, there is lower adherence to established clinical guidelines and poorer health outcomes for children seeking emergency care in non-pediatric centres. 8 To bridge the research-to-practice gap and raise the overall standard of care in pediatric emergency medicine, it is imperative to support knowledge mobilization within general EDs.…”

Section: Introductionmentioning

confidence: 99%

Pediatric information seeking behaviour, information needs, and information preferences of health care professionals in general emergency departments: Results from the Translating Emergency Knowledge for Kids (TREKK) Needs Assessment

Scott

Albrecht

Given

et al. 2017

CJEM

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on behalf of the TREKK team ABSTRACTThe majority of children requiring emergency care are treated in general emergency departments (EDs) with variable levels of pediatric care expertise. The goal of the Translating Emergency Knowledge for Kids (TREKK) initiative is to implement the latest research in pediatric emergency medicine in general EDs to reduce clinical variation. Objectives: To determine national pediatric information needs, seeking behaviours, and preferences of health care professionals working in general EDs. Methods: An electronic cross-sectional survey was conducted with health care professionals in 32 Canadian general EDs. Data were collected in the EDs using the iPad and in-person data collectors. Results: Total of 1,471 surveys were completed (57.1% response rate). Health care professionals sought information on children's health care by talking to colleagues (n = 1,208, 82.1%), visiting specific medical/health websites (n = 994, 67.7%), and professional development opportunities (n = 941, 64.4%). Preferred child health resources included protocols and accepted treatments for common conditions (n = 969, 68%), clinical pathways and practice guidelines (n = 951, 66%), and evidence-based information on new diagnoses and treatments (n = 866, 61%). Additional pediatric clinical information is needed about multisystem trauma (n = 693, 49%), severe head injury (n = 615, 43%), and meningitis (n = 559, 39%). Health care professionals preferred to receive child health information through professional development opportunities (n = 1,131, 80%) and printed summaries (n = 885, 63%). Conclusion:By understanding health care professionals' information seeking behaviour, information needs, and information preferences, knowledge synthesis and knowledge translation initiatives can be targeted to improve pediatric emergency care. The findings from this study will inform the following two phases of the TREKK initiative to bridge the research-practice gap in Canadian general EDs. RÉSUMÉContexte: La plupart des enfants ayant besoin de soins d'urgence sont traités dans des services des urgences (SU) généraux dotés, à des degrés variables, de spécialistes en soins pédiatriques. L'initiative Translating Emergency Knowledge for Kids (TREKK) a pour but l'application des résultats les plus récents de la recherche en médecine d'urgence pédiatrique dans les SU généraux afin d'atténuer les différences de soins cliniques. Objectif: L'étude décrite ici visait à déterminer, à l'échelle nationale, les besoins d'information en pédiatrie des professionnels de la santé travaillant dans des SU généraux, leurs comportements dans la recherche d'information ainsi que leurs préférences quant à l'obtention d'information. Méthode: Il s'agit d'une enquête transversale électronique, menée parmi des professionnels de la santé, dans 32 services des urgences généraux, au Canada. La collecte de donnée dans les SU s'est faite à l'aide de tablettes électroniques (iPad) et de consignateurs de données, en personne. Résultats: Au total, 1471 question...

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Section: Introductionmentioning

confidence: 99%

Pediatric information seeking behaviour, information needs, and information preferences of health care professionals in general emergency departments: Results from the Translating Emergency Knowledge for Kids (TREKK) Needs Assessment

Scott

Albrecht

Given

et al. 2017

CJEM

View full text Add to dashboard Cite

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“…A recent review of the literature on this topic failed to show differences in pediatric health outcomes when comparing provider type and setting with the exception of trauma care. 17 Notably, previous studies suggest that nonYchildren's hospitals with a separate pediatric ED tend to be better prepared for pediatric emergency visits in terms of pediatric expertise, equipment, and policies and procedures, suggesting that it may be more important to focus on ''how'' care is being delivered rather than ''who'' is providing the care ( In this study, the acuity of pediatric patients is low, significant trauma is directed to a pediatric trauma center, and there are board-certified emergency physicians available on site to provide additional support as needed. We agree with national recommendations that the regionalization of pediatric care, linking community hospitals to a pediatric medical center, is important to deliver high-level emergency care to critically ill and injured patients by directing such patient to facilities with increased capabilities.…”

Section: Discussionmentioning

confidence: 99%

Community Pediatric Hospitalists Providing Care in the Emergency Department

Dudas

Monroe²,

Borger

2011

Pediatric Emergency Care

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“…Approximately 75% of pediatric emergency care visits occur in general EDs, [1][2][3][4] likely reflecting families seeking care closer to home. Regardless of where they present, all children deserve quality emergency care.…”

Section: Introductionmentioning

confidence: 99%

Evidence based pediatric care closer to home: A mixed methods evaluation of a clinical pathways-based emergency outreach program

Jabbour

Reid

Irwin

et al. 2017

JHA

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Objective: While specialized pediatric care is not feasible in all Emergency Department (ED) settings, enhanced system capacity is needed to appropriately address pediatric emergency care needs. Our objective was to evaluate an innovative clinical pathway (CP) based regional ED outreach program within community EDs. Methods: This mixed-methods design includes pre/post chart audits, qualitative interviews, ED site audits, and website utilization metrics. The study was conducted in community-based hospital EDs within the region. ED nurses, physicians and administrators from eight hospitals participated in the study. The ED outreach program involved implementation of 3 CPs addressing common pediatric emergency presentations: asthma, croup and gastroenteritis. Primary outcomes from chart audits included presence of a CP-related document filed in relevant patient charts and the proportion of patients who received appropriate care as per the severity-based CP recommendations. Secondary outcomes included documented assessments of condition severity, use of specific treatments and hospital metrics. Results: ED health professionals value the outreach initiative and CPs. Site audits confirmed ED presence and knowledge of CP tools. However several adoption barriers were identified, including time, perceived threats to physician autonomy and infrequent opportunities for use. Chart audits demonstrated site-dependent, variable uptake of CP resources into ED workflows. In total, 1,274 health records were audited, with the following pre/post breakdowns: 203/211 (asthma), 131/193 (croup) and 291/245 (gastroenteritis). We could not evaluate our primary outcomes due to infrequent documentation of condition severity. Significant post-implementation improvements were demonstrated in gastroenteritis management. Median length of stay remained unchanged (asthma) or increased (croup, gastroenteritis). ED site was an important predictor of some asthma treatments and LOS for asthma (p < .001), croup (p = .01) and gastroenteritis (p < .001). Conclusions: CP documents were available in EDs, but may not be utilized as fully intended. Site heterogeneity may account for lack of significant change in several outcome variables.

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Children in emergency departments: who should provide their care?

Cited by 9 publications

References 37 publications

Pediatric information seeking behaviour, information needs, and information preferences of health care professionals in general emergency departments: Results from the Translating Emergency Knowledge for Kids (TREKK) Needs Assessment

Pediatric information seeking behaviour, information needs, and information preferences of health care professionals in general emergency departments: Results from the Translating Emergency Knowledge for Kids (TREKK) Needs Assessment

Community Pediatric Hospitalists Providing Care in the Emergency Department

Evidence based pediatric care closer to home: A mixed methods evaluation of a clinical pathways-based emergency outreach program

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