Pediatric emergency department directors' benchmarking survey: fiscal year 2001

To answer basic questions, using precise definitions, regarding emergency department (ED) utilization, wait times, services, and attending physician staffing of representative pediatric EDs (PEDs).

Ten questions with precise definitions were developed and sent to members of the Ambulatory Pediatric Association's PED Directors' Special Interest Group in November of 2001, with two repeated requests 3 and 6 months later.

Twenty-one PEDs from 14 states, the District of Columbia, and Canada responded (41%). The average PED has 48,000 patient visits per year (range, 25,000-97,000). Two thirds have urgent care or fast track areas to see nonurgent patients, while only 29% have 23-hour treatment units. The average admission rate is 13.2% (range, 6.8-20.8%). The average rate of patients who leave without being seen is 1.6%. The average patient waits 1 hour to see a physician and spends a total of 3 hours in the PED. The majority of attending staffing is by pediatric emergency medicine (PEM) Board-certified/eligible physicians (73%), although a few PEDs are staffed only by PEM specialists. Attending staffing is 2.8 patients per attending per hour, or 0.36 hours per patient, with more staffing for PEDs with higher admission rates or acuity. The average entry-level base salary for PED physicians in 2000 was 117,250 dollars (range, 98,000 dollars-145,000 dollars).

Benchmarking of PEM staffing and performance indicators by PEM directors yields important administrative data. PEDs have higher census and admission rates compared with information from all EDs, while their attending staffing, wait times, and rate of patients who leave without being seen are comparable to those of general EDs.