District paediatric day care.

Abstract

Although there have been several recent papers published on the results of day case surgery in children, little has been written on hospital-based day care for medical problems; in spite of this lack of information we believe many paediatric units provide this service. This paper describes our attempts to organize medical day cases on a general paediatric ward, and analyses some problems encountered. It is written in the hope that it will stimulate others to report their experience in this field. Experience in Canada (H.T.D.)The need for alternative hospital care facilities for children in British Columbia was studied in 1967 (Robinson et al., 1969). For two-thirds of the children standard inpatient care was still appropriate, but 30% were thought suitable for day care with a surgical to medical ratio of 3:1. One-half of the children qualifying for day care were of preschool age. Parents of inpatients who seemed suitable for day care were asked if they would choose that method when it was available.45 % thought it a preferable form of care, but many parents had doubts about safety and their ability to cope.The surgical patients were further investigated. A study nurse was employed and 116 controlexperimental pairs of children were matched for type of operation, age, sex, and socioeconomic and educational class (Davenport, Shah, and Robinson, 1971;Shah et al., 1972). The complication rate of those discharged on the day of operation was compared with that of children remaining in hospital. Complications were similar, being few and mild in both groups. Pain and cough were recorded more often at home and unhappiness

Multi-method evaluation of a paediatric ambulatory care unit (PACU): impact on families and staff

“…Such innovative proposals have a long history and are in line with the National Service Framework for Children 2 9 10. A recent systematic review showed that ambulatory care is becoming an acceptable alternative to inpatient admission, but that more research on impact is required 7…”