Paediatric short stay unit in a community hospital: Effective, efficient and popular

Abstract

A co-located paediatric SSU within an ED is an efficient, popular and viable alternative for paediatric services to be delivered in a suburban setting.

Changes in the epidemiology of gastroenteritis in a paediatric short stay unit following the introduction of rotavirus immunisation

“…It is designed to care for children with a defined range of conditions requiring inpatient treatment with an anticipated length of hospital stay of less than 36 h. Acute gastroenteritis (AGE) has comprised a significant proportion of the workload within the unit, being one of the top two discharge diagnoses in its first 2 years. This is similar to the reported experience of other paediatric SSUs . Although a significant proportion of AGE requiring inpatient management at the RCH is managed in the SSU, patients felt likely to have a prolonged length of stay (e.g.…”

Alternatives to ward admission from the emergency department

“…Approximately, one third of paediatric admissions from the ED are suitable for an observation unit and another third to half for a SSU . These illnesses can encompass up to 80% of emergency admissions in a non‐tertiary setting, but probably a smaller percentage in a tertiary setting because of the larger numbers of complex cases .…”

“…Beyond the principles outlined earlier, the particular staffing model, target patient group, location and business rules of such units develop uniquely within each institution in the context of demand, patient mix, staff skills and available space and financial resources. For instance, a large ED in a tertiary paediatric centre may aim to relocate patients who need 3–8 h of care from ED trolleys, thereby freeing both ED cubicles and inpatient beds, whereas a mixed community ED with no inpatient paediatric beds might reduce transfers to other centres and improving access to paediatric staff . Demand for the use of SSUs may vary over time, either because of changing patient conditions (e.g.…”

“…Potential benefits of short stay care include: reduced inpatient time, improved patient and parent comfort and satisfaction, cost effectiveness, improved ED flow, improved patient access and reduction in inpatient hospital admissions . A successful short stay admission constitutes disease improvement, discharge within the pre‐defined timeframe and no unplanned return with the same disease.…”