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Multi-method evaluation of a paediatric ambulatory care unit (PACU): impact on families and staff

M Blair1, J Gore, F Isaza

  • 1Imperial College, London and River Island Paediatric and Child Health Academic Centre, Northwick Park Hospital Campus, Harrow, Middlesex, UK. m.blair@imperial.ac.uk

Archives of Disease in Childhood
|March 14, 2008
PubMed

Insights

A new pediatric ambulatory care unit (PACU) significantly improved patient journeys and parental satisfaction compared to traditional A&E services. This model offers a highly valued, effective alternative for acute pediatric care.

Area of Science:

  • Pediatric Emergency Medicine
  • Healthcare Management
  • Patient Experience Research

Background:

  • Traditional Accident & Emergency (A&E) services face challenges in managing acute pediatric cases efficiently.
  • There is a need for specialized units to improve the patient journey and satisfaction in pediatric ambulatory care.

Purpose of the Study:

  • To evaluate the impact of a purpose-built Pediatric Ambulatory Care Unit (PACU) on patient journeys.
  • To assess parental, staff, and referrer perceptions of the PACU model.
  • To compare the PACU with traditional A&E services.

Main Methods:

  • Multi-method evaluation including parent surveys (n=104), patient journey mapping (n=10), staff interviews (n=10), and referrer surveys (n=16).
  • Comparison with Accident & Emergency (A&E) service data (parent survey n=41).
  • Routine activity analysis of the patient pathway.

Main Results:

  • 94% of parents were satisfied with PACU, significantly higher than A&E (51% vs 31%).
  • 77% of PACU parents preferred it over A&E; reported reduced anxiety (55% to 13%), quick waits (median 35 min), and enhanced understanding.
  • PACU reduced patient journey stages from six to four; staff/referrers deemed it superior but noted referral and multidisciplinary protocol needs.

Conclusions:

  • The PACU model is an effective alternative to standard A&E for acute pediatric assessment and early management.
  • The PACU is highly valued by patients, families, staff, and referrers, enhancing the overall patient journey.
  • Future improvements should focus on multidisciplinary processes and clarifying the PACU's role within the broader healthcare system.
Abstract

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