Alexandra Camargo1,2, Krislyn M Boggs2, Marc Auerbach3, Rachel D Freid2,4, Ashley F Sullivan2, Janice A Espinola2, Carlos A Camargo2. 1. Stanford University, Stanford, CA. 2. Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA. 3. Department of Emergency Medicine and Pediatrics, Yale University School of Medicine, New Haven, CT. 4. Department of Environmental Health, Boston University School of Public Health, Boston, MA.
Abstract
OBJECTIVES: While many U.S. emergency departments (ED) have a "pediatric ED," there are, to our knowledge, no accepted criteria for this type of ED. We investigated the prevalence, distribution, staffing, and characteristics of self-reported pediatric areas in U.S. general EDs. METHODS: We conducted a survey of all 5,273 U.S. EDs to characterize emergency care in 2015. We then surveyed 130 of the 426 general EDs who reported having a pediatric area. Data collection for the second survey included confirmation of a pediatric area and information on that area's structure and staffing. RESULTS: The national survey (85% response) showed 10% of general EDs reported a pediatric area. Only 16% of all U.S. EDs had a pediatric emergency care coordinator (PECC). EDs with larger visit volumes, or in the Northeast or South, were more likely to have a pediatric area. Nine states had no general EDs with pediatric areas. Among general EDs with a pediatric area, 75% had a PECC and 74% had a board-certified or board-eligible pediatric emergency medicine (PEM) physician on staff. Ninety-three percent had designated pediatric beds. Rarely (3%) was the pediatric area just a separate waiting area within a general ED, without any PECC or PEM physician present. CONCLUSIONS: We found that 10% of U.S. general EDs had a pediatric area and that this prevalence varies nationwide. Moreover, only 16% of U.S. EDs had a PECC. Further studies on the impact of ED structure and staffing on pediatric care and patient outcomes are urgently needed. As a long-term objective, a standardized definition of a pediatric ED would not only help quality improvement efforts but also help families make more informed choices about where to bring their children to receive care.
OBJECTIVES: While many U.S. emergency departments (ED) have a "pediatric ED," there are, to our knowledge, no accepted criteria for this type of ED. We investigated the prevalence, distribution, staffing, and characteristics of self-reported pediatric areas in U.S. general EDs. METHODS: We conducted a survey of all 5,273 U.S. EDs to characterize emergency care in 2015. We then surveyed 130 of the 426 general EDs who reported having a pediatric area. Data collection for the second survey included confirmation of a pediatric area and information on that area's structure and staffing. RESULTS: The national survey (85% response) showed 10% of general EDs reported a pediatric area. Only 16% of all U.S. EDs had a pediatric emergency care coordinator (PECC). EDs with larger visit volumes, or in the Northeast or South, were more likely to have a pediatric area. Nine states had no general EDs with pediatric areas. Among general EDs with a pediatric area, 75% had a PECC and 74% had a board-certified or board-eligible pediatric emergency medicine (PEM) physician on staff. Ninety-three percent had designated pediatric beds. Rarely (3%) was the pediatric area just a separate waiting area within a general ED, without any PECC or PEM physician present. CONCLUSIONS: We found that 10% of U.S. general EDs had a pediatric area and that this prevalence varies nationwide. Moreover, only 16% of U.S. EDs had a PECC. Further studies on the impact of ED structure and staffing on pediatric care and patient outcomes are urgently needed. As a long-term objective, a standardized definition of a pediatric ED would not only help quality improvement efforts but also help families make more informed choices about where to bring their children to receive care.
Authors: Margaret E Samuels-Kalow; Ashley F Sullivan; Krislyn M Boggs; Jingya Gao; Elizabeth R Alpern; Carlos A Camargo Journal: J Am Coll Emerg Physicians Open Date: 2021-06-22