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Pediatric emergency room response to community pediatricians' expectations
J Urkin1, S S Warshawsky, J Press
1Department of Pediatrics, Soroka Medical Center, Beer Sheva, Israel. urkin@bgumail.bgu.ac.il
Insights
Pediatric emergency rooms (PERs) in Israel function as primary care clinics. Physician expectations and referral information do not significantly impact PER patient management, highlighting a communication gap.
Area of Science:
- Pediatric Emergency Medicine
- Primary Care
- Healthcare Communication
Background:
- Pediatric emergency rooms (PERs) in Israel serve as primary care clinics alongside emergency services.
- Most patients are referred to PERs from community clinics due to insurance policies.
- The link between referring physician expectations and PER patient management is unclear.
Purpose of the Study:
- To assess the relationship between primary care physician expectations and PER patient management.
- To evaluate the quality of information provided in referrals.
- To determine if additional information impacts PER physician decisions.
Main Methods:
- Review of patient records from PERs with community clinic referrals.
- Telephone interviews with referring physicians to gather additional information.
Main Results:
- Referring physician expectations were often not documented in referral forms.
- PER physicians treated patients as if they were the first point of contact.
- No significant difference in PER management was observed with or without additional referral information.
Conclusions:
- PERs operate independently, not necessarily aligning with referring physician expectations.
- Improved communication and structured referral forms are needed between primary care and PERs.
- Clearer guidelines are essential for better patient care and provider collaboration.
Background:
In Israel the pediatric emergency room functions as an urgent primary care clinic in addition to dealing with life-threatening situations. Due to health insurance stipulations, most patients come to the PER with a referral from the community clinic. The relationship between the referring physician's expectations and the subsequent management of the referred patient in the PER is not well defined.
Objectives:
To evaluate the relationship between the expectations of the primary care physician and the management of referred patients in the PER, assess the type of information provided by the referring physician, and examine the effect of additional information obtained from the referring physician on patient management in the PER.
Methods:
We reviewed the records of patients presenting at the PER with referrals from primary care physicians as well as additional information obtained by telephone interviews with the referring physicians.
Results:
The expectations of the referring physicians were not fully documented in the referral form. The PER responded to the patient as if the PER was the initial contact. There was no significant difference in the response of PER physicians with or without additional information from the referring physicians.
Conclusions:
The PER acts as an independent unit with no obligation to satisfy the expectations of the referring physicians. The relationship between the PER and the referring physicians needs to be clarified. Guidelines and structured PER referral forms should be implemented in all primary care clinics to improve patient management and communication between health providers.
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