The Impact of Universal Mental Health Screening on Pediatric Emergency Department Flow

Paired analysis of ED efficiency for low-acuity children treated by PAs and pediatricians

“…Of note, we used a tighter threshold for considering possible clinically relevant differences in ED LOS than has been used in prior literature. When considering the effect of system changes on LOS for ED patients of every acuity level, +/- 30 minutes may be more appropriate as a threshold for clinically important changes to LOS 13,14. In conversations with our study team and clinicians who regularly work in our fast-track area, we chose a tighter clinically important difference threshold of 15 minutes because efficient care is especially important for low-acuity patients, given the relatively uncommon need for hospital admission, specialty consultation, or extensive diagnostic workups.…”

“…When considering the effect of system changes on LOS for ED patients of every acuity level, +/-30 minutes may be more appropriate as a threshold for clinically important changes to LOS. 13,14 In conversations with our study team and clinicians who regularly work in our fast-track area, we chose a tighter clinically important difference threshold of 15 minutes because efficient care is especially important for low-acuity patients, given the relatively uncommon need for hospital admission, specialty consultation, or extensive diagnostic workups. Our group has previously used 15 minutes, about 10% of our mean fast-track LOS, as a clinically important threshold to evaluate the effect of system changes on LOS for urgent care patients.…”