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Parental preferences for boarding locations when a children's hospital exceeds capacity
Bridgette D Guthrie1, William D King, Kathy W Monroe
1Northwestern University Feinberg School of Medicine, Chicago, IL, USA. b-guthrie@md.northwestern.edu
Insights
Parents prefer pediatric patients to board in inpatient hallways over emergency department hallways when children's hospitals are at capacity. Most parents would wait at the children's hospital, even if crowded.
Area of Science:
- Pediatric healthcare management
- Patient satisfaction studies
- Hospital capacity planning
Background:
- Children's hospitals face capacity challenges, leading to patient boarding.
- Understanding parental preferences is crucial for managing crowded conditions and maintaining patient satisfaction.
Purpose of the Study:
- To determine parental preferences for boarding locations (inpatient vs. emergency department hallways) during pediatric hospital overcrowding.
- To assess parental willingness to transfer to a general hospital when a children's hospital is at full capacity.
Main Methods:
- A survey was administered to parents of eligible pediatric patients within 24 hours of admission.
- Parents were asked about their preferences for boarding locations, maximum acceptable waiting times, and interest in transfer to another facility.
Main Results:
- Over 58% of parents preferred inpatient hallway boarding, while 11% preferred emergency department hallway boarding.
- Approximately 70% of parents preferred to wait at the children's hospital despite crowding.
- Most parents indicated a maximum acceptable waiting time of 3 hours or less.
Conclusions:
- Parents of pediatric patients favor inpatient hallway boarding over emergency department hallway boarding.
- The majority of parents prioritize staying at a children's hospital, though some are open to transfer.
- Findings can inform strategies to enhance patient satisfaction during periods of exceeded hospital capacity.
Study Objective:
Our objective is to determine parental preferences for boarding locations when a children's hospital is at full capacity. We also assess parental interest in transfer to a general hospital when a children's hospital is experiencing crowding.
Methods:
Eligible patients were surveyed within 24 hours of admission. Surveys were completed in emergency department (ED) and inpatient areas. Previous admission was not required; children with chronic illnesses were included. Parents were asked whether they would prefer their child to board in an ED hallway or inpatient hallway or whether they had no preference. Parents were also asked the maximum acceptable waiting time for an inpatient bed and whether they would prefer to be transferred to another hospital should the children's hospital not have a bed available. Responses were hypothetical and confidential and did not affect care.
Results:
A total of 382 patients met enrollment criteria and 359 (94%) were enrolled; 58.8% (95% confidence interval [CI] 53.5% to 63.9%) preferred boarding on inpatient hallways, 11.1% (95% CI 8.2% to 15.0%) preferred ED hallways, and 30.1% (95% CI 25.4% to 35.2%) had no preference. Seventy percent (95% CI 65.2% to 74.9%) of parents preferred to wait at a children's hospital despite crowding. Most parents believed that the maximum acceptable waiting time was less than or equal to 3 hours.
Conclusion:
Parents of pediatric patients prefer boarding on inpatient hallways over ED hallways. The majority of parents prefer to remain at a children's hospital despite crowded conditions, but some parents may be amenable to transfer. These results may help institutions develop strategies to improve patient satisfaction when hospital capacity is exceeded.
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