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Caregiver Perspectives on Including Children in Alternative Emergency Medical Services Disposition Programs: A

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Caregivers generally support alternative emergency medical services (EMS) dispositions for children with low-acuity needs, citing benefits like faster care. However, they have concerns about safety, logistics, and retaining decision-making authority.

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Area of Science:

  • Emergency Medical Services (EMS)
  • Pediatric Healthcare
  • Health Services Research

Background:

  • Nearly half of pediatric emergency medical services (EMS) calls are for low-acuity issues.
  • Alternative disposition programs exist for adults but present unique challenges for children.
  • Caregiver perspectives on these programs for pediatric patients are not well-documented.

Purpose of the Study:

  • To explore caregiver perspectives on alternative EMS disposition systems for low-acuity pediatric patients.
  • To identify potential benefits and concerns from the caregiver viewpoint.
  • To inform the design of pediatric alternative disposition programs.

Main Methods:

  • Six virtual focus groups were conducted with 38 caregivers, including one in Spanish.
  • A semi-structured moderator guide was used, and a PhD-trained facilitator moderated.
  • A hybrid inductive and deductive analytical strategy with thematic saturation was employed.

Main Results:

  • Caregivers generally support alternative EMS dispositions for children, recognizing benefits like resource optimization and quicker care.
  • Key concerns include the timeliness and capabilities of receiving sites, care coordination, and safety of alternative transport.
  • Logistical issues such as taxi safety, parental autonomy, and equitable implementation were also raised.

Conclusions:

  • Caregivers are generally supportive of alternative EMS dispositions for some pediatric cases, acknowledging system and patient benefits.
  • Concerns regarding safety, logistics, and the need for caregiver involvement in decision-making are paramount.
  • Caregiver insights are crucial for developing and implementing effective and equitable alternative EMS disposition programs for children.