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Physician satisfaction with a pediatric observation unit administered by pediatric emergency medicine physicians
Alison C Rentz1, Howard A Kadish, Douglas S Nelson
1Department of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah School of Medicine, USA.
Insights
Community physicians are highly satisfied with the pediatric observation unit (OU) model, finding it useful for treating common childhood illnesses. Initial concerns about emergency department (ED) control have not impacted physician satisfaction.
Area of Science:
- Pediatric Emergency Medicine
- Healthcare Management
- Clinical Operations
Background:
- Observation units (OUs) are established for adult care, but their pediatric application and physician perceptions are less documented.
- Primary medical doctors (PMDs) initially expressed concerns regarding the management of their patients within a pediatric OU controlled by emergency physicians.
Purpose of the Study:
- To assess the satisfaction levels of community and subspecialty physicians with a pediatric observation unit (OU) approximately two and a half years after its implementation.
- To evaluate physician perceptions of the pediatric OU's utility in managing common pediatric conditions.
Main Methods:
- A satisfaction survey utilizing a 4-point Likert scale was distributed to pediatricians, family practitioners, and pediatric subspecialists.
- The survey collected data on physician satisfaction across four key areas and assessed the perceived utility of the OU for specific pediatric illnesses.
Main Results:
- A response rate of 80% (198/248) was achieved, with pediatricians and family practitioners forming the majority of respondents.
- Median satisfaction scores were uniformly high (4 out of 4) across all measured domains.
- Over 60% of surveyed physicians found the OU beneficial for treating conditions such as dehydration, gastroenteritis, reactive airway disease, and bronchiolitis.
Conclusions:
- The pediatric observation unit (OU) model, managed by the emergency department (ED), has achieved high physician satisfaction.
- Initial concerns from community physicians regarding the OU model have not materialized, indicating successful integration and operation.
Objectives:
Observation units (OUs) are widely used to care for adults, but little is published about their use in pediatrics. During the planning stages of our pediatric OU, community primary medical doctors (PMDs) expressed concerns about not admitting and managing their own patients in this unit controlled by pediatric emergency physicians. This study surveyed PMDs to determine their satisfaction with the pediatric OU two and a half years after opening.
Methods:
A satisfaction survey was mailed to pediatricians, family practitioners, and pediatric subspecialists whose patients had been admitted to the study pediatric OU from August 1999 to January 2002. A Likert scale ranging 1 to 4 was used to measure satisfaction in 4 areas. In addition, there were questions regarding the utility of the OU for treatment of common pediatric illnesses.
Results:
198 of 248 (80%) surveys were returned. Pediatricians (64%) and family practitioners (23%) were represented most often. Fifty-three percent of PMD respondents had 10 or more patients admitted during the study period. Median satisfaction scores were 4 (most satisfied) in all areas measured. Over 60% of physicians surveyed felt that the OU was useful in the treatment of dehydration, gastroenteritis, reactive airway disease, and bronchiolitis.
Conclusions:
The model of an ED-controlled pediatric observation unit received high satisfaction ratings in all areas by community and subspecialty physicians two and a half years after opening. The initial reservations voiced by community physicians have not resurfaced.
