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Pediatric emergency department complaints: a three-year analysis of sources and trends
V T Chande1, M S Bhende, H W Davis
1Department of Pediatrics, Children's Hospital of Pittsburgh, Pennsylvania 15213.
Insights
Patient complaints in pediatric emergency departments (EDs) occurred at a rate of 1.1 per 1,000 visits, with misdiagnosis and billing being key issues. Analyzing these complaints aids in improving patient care quality.
Area of Science:
- Pediatric Emergency Medicine
- Patient Safety
- Healthcare Quality Improvement
Background:
- Patient and parental complaints in emergency departments (EDs) offer valuable insights into care quality.
- Understanding complaint trends is crucial for targeted service enhancements.
Purpose of the Study:
- To determine the incidence and primary causes of patient and parental complaints within a pediatric emergency department.
- To identify specific areas of dissatisfaction to inform quality improvement initiatives.
Main Methods:
- A retrospective analysis was conducted on all complaints received over a three-year period (January 1987 to December 1989).
- Complaints were categorized by reason, validity, and the specific location within the ED where the patient received care.
Main Results:
- A total of 176 complaints were recorded from 154,648 ED visits, resulting in an overall incidence of 1.1 complaints per 1,000 patient visits.
- The most frequent reasons for complaints included misdiagnosis, billing issues, and inadequate treatment, with 49% deemed valid.
- Nonurgent medical cases had a higher complaint rate (0.69/1,000 visits) compared to emergent cases (critical care and trauma) (0.08/1,000 visits).
Conclusions:
- Evaluating patient and parental complaints is an effective method for identifying areas of dissatisfaction.
- This analysis provides a foundation for developing strategies to enhance the quality of patient care in pediatric emergency settings.
Study Objective:
To identify the incidence and major causes of patient and parental complaints in a pediatric emergency department.
Design:
Retrospective analysis of complaints received regarding patients seen between January 1987 and December 1989.
Setting:
ED of Children's Hospital of Pittsburgh.
Participants:
All complaints received during the three-year period.
Interventions:
Complaints were reviewed for reason, validity, and location at which patient was seen.
Measurements And Results:
One hundred seventy-six complaints from a total of 154,648 ED visits yielded a frequency of 1.1 complaints per 1,000 patient visits. Main reasons for dissatisfaction were misdiagnosis, billing, and inadequate treatment; 49% of complaints were judged valid. There were 0.69 complaints per 1,000 patient visits in the nonurgent medical portion of the ED. Patients seen emergently (critical care and trauma) had a significantly lower complaint frequency of 0.08 per 1,000 patient visits (P less than .001 by chi 2 analysis).
Conclusion:
Assessment of ED complaints is useful to highlight areas of patient dissatisfaction and develop plans for improving patient care.