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The impact of an emergency care access point on pediatric attendances at the emergency department: An observational

Mireille E M Platter1, Roel A J Kurvers2, Loes Janssen3

  • 1Department of Emergency Medicine, VieCuri Medical Center, Venlo, the Netherlands; Department of Pediatrics, VieCuri Medical Center, Venlo, the Netherlands.

The American Journal of Emergency Medicine
|February 13, 2019
PubMed

Insights

Implementing an Emergency Care Access Point (ECAP) significantly reduced pediatric emergency department visits by 16.3%, with a notable decrease in self-referrals. This intervention shows promise for alleviating pediatric ED workload.

Area of Science:

  • Emergency Medicine
  • Pediatric Healthcare
  • Primary Care Integration

Background:

  • Emergency Departments (EDs) face increasing crowding, particularly in pediatrics.
  • Self-referrals and non-urgent visits contribute to ED overcrowding.
  • The Emergency Care Access Point (ECAP) model aims to manage patient flow by integrating general practitioners with EDs.

Purpose of the Study:

  • To evaluate the impact of implementing an ECAP on pediatric attendance rates in an Emergency Department.
  • To assess changes in patient characteristics, complaints, diagnoses, and throughput post-ECAP implementation.

Main Methods:

  • Retrospective analysis of 3997 pediatric patients.
  • Comparison of data from one year before and one year after ECAP implementation.
  • Analysis included patient demographics, presenting complaints, diagnoses, and follow-up care during and after office hours.

Main Results:

  • A 16.3% reduction in overall pediatric ED visits was observed post-ECAP.
  • Self-referrals decreased by 97.2% after ECAP implementation.
  • Patient acuity remained similar, but consultation and follow-up frequency increased; nighttime admission rates rose, while overall admission rates were comparable.

Conclusions:

  • ECAP implementation effectively reduced pediatric ED utilization and self-referrals.
  • The intervention did not alter patient acuity, suggesting appropriate redirection of non-urgent cases.
  • ECAPs represent a viable primary care strategy to reduce pediatric ED workload, warranting further investigation in diverse settings.
Abstract

Keywords:
CrowdingEmergency care access pointEmergency departmentPediatricPrimary care

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