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Emergency review clinic: impact on paediatric admissions
B Rai1, F McCartan2, S Moka2
1Department of Pediatrics, Midland Regional Hospital, Mullingar, Ireland. drbirendrarai@gmail.com.
Insights
Establishing a paediatric emergency review clinic significantly reduced inpatient admissions. This strategy offers a promising approach to optimize paediatric care and reduce healthcare system strain.
Area of Science:
- Pediatric Emergency Medicine
- Healthcare Management
- Clinical Operations
Background:
- Inappropriate paediatric inpatient admissions are costly and strain healthcare services.
- Previous measures like paediatric observation units aimed to mitigate these admissions.
- Unnecessary admissions impact resource allocation and patient flow.
Purpose of the Study:
- To evaluate the effectiveness of an emergency review clinic in reducing paediatric inpatient admission rates.
- To assess the impact of follow-up review appointments for selected children seen in the Emergency Department (ED).
Main Methods:
- An emergency review clinic was implemented, staffed by a senior paediatric registrar.
- The clinic operated weekdays from 10 a.m. to 12 p.m. within the ED.
- Paediatric admission data from before and after the clinic's establishment were analyzed.
Main Results:
- A statistically significant reduction in paediatric inpatient admission rates was observed post-implementation (p < 0.0001).
- The review clinic demonstrated a clear positive impact on admission trends.
Conclusions:
- A paediatric emergency review clinic effectively reduces unnecessary or inappropriate admissions.
- Further research is recommended to quantify patient and parent satisfaction with this model.
Background:
Inappropriate or unnecessary paediatric inpatient admissions are sometimes unavoidable but are costly and increase pressure on services. Various measures, including paediatric observation units, have been undertaken in an attempt to reduce these admissions.
Aims:
We established an emergency review clinic to assess whether we could reduce admission rates by giving carefully selected children follow-up ED review appointments.
Methods:
An emergency review clinic was run in the paediatric room of the Emergency Department by a senior paediatric registrar during the hours 10 a.m. to 12 midday, Monday to Friday inclusive. Patients were booked into this review clinic from ED. Data relating to paediatric admissions in the years prior to and after the institution of the review clinic were analysed.
Results:
A significant reduction (p < 0.0001) was noted in the paediatric inpatient admission rates following establishment of the review clinic.
Conclusions:
A paediatric emergency review clinic can significantly reduce unnecessary or inappropriate admissions but more research is needed to quantitatively characterise parent/patient satisfaction in this regard.
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