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Updated: Aug 3, 2025

Event Related Potentials ERPs and other EEG Based Methods for Extracting Biomarkers of Brain Dysfunction: Examples from Pediatric Attention Deficit/Hyperactivity Disorder ADHD
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Paired analysis of ED efficiency for low-acuity children treated by PAs and pediatricians

Kenneth W McKinley1, Jennifer Q Tran, James M Chamberlain

  • 1At Children's National Hospital in Washington, D.C., Kenneth W. McKinley practices in the Emergency Medicine Section of Data Analytics, Jennifer Q. Tran practices in Emergency Medicine and Trauma Services, and James M. Chamberlain and Deena D. Berkowitz practice in the Emergency Medicine Section of Data Analytics. The authors have disclosed no potential conflicts of interest, financial or otherwise.

JAAPA : Official Journal of the American Academy of Physician Assistants
|April 12, 2023
PubMed

Insights

Pediatric emergency department (ED) patients with low-acuity conditions treated by physician assistants (PAs) had a length of stay (LOS) that was not clinically important compared to those seen by pediatricians.

Area of Science:

  • Pediatric Emergency Medicine
  • Healthcare Quality Improvement
  • Clinical Operations

Background:

  • The role of advanced practice providers, such as physician assistants (PAs), is expanding in pediatric emergency departments (EDs).
  • Understanding the impact of PA versus pediatrician care on patient flow is crucial for optimizing ED operations.

Purpose of the Study:

  • To compare the length of stay (LOS) for low-acuity pediatric patients treated by PAs versus pediatricians in a large, urban ED.
  • To determine if the difference in LOS exceeded a clinically important threshold of 15 minutes.

Main Methods:

  • A paired analysis was conducted on data collected between July 2017 and February 2020.
  • Length of stay (LOS) was measured for low-acuity pediatric patients during overlapping shifts staffed by both PAs and pediatricians in the ED.
  • Mean LOS differences were calculated for shifts with shared staffing.

Main Results:

  • The mean shift LOS for children seen by PAs was 160.1 minutes (SD: 48.6).
  • The mean shift LOS for children seen by pediatricians was 150 minutes (SD: 47.3).
  • The mean LOS for PA-treated patients was 10.1 minutes longer than for pediatrician-treated patients (95% CI: 6.1, 14.1).

Conclusions:

  • No clinically important difference in length of stay was identified for low-acuity pediatric patients treated by PAs compared to pediatricians.
  • These findings suggest that PAs can manage low-acuity pediatric ED visits efficiently without significantly impacting patient flow.
Abstract

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