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Non-Emergent Presentations to a children's emergency department : Are Identifiable Barriers to Continuity of Care a Contributing Factor?

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Author	DiLeo, Erica Lyn, 1985-
Title	Non-Emergent Presentations to a children's emergency department : Are Identifiable Barriers to Continuity of Care a Contributing Factor?
Resource Type	Text
Abstract	Pediatric Emergency Departments (PED) are challenged by high volume utilization for non-emergent complaints that often could be managed by a primary care practitioner. This leads to poor PED resource utilization and extended wait times for patients/families. To look into this, a study was conducted to identify barriers to primary care utilization for patients presenting to pediatric emergency departments (PED) with non-emergent complaints. An eight-question written survey was distributed to a convenience sample of patients/families that met Level IV triage guidelines in a four tier triage system, and who presented to the Yale-New Haven Children's Hospital PED, an urban tertiary care center. Level IV triage designation is considered non-emergent and a primary care practitioner may have provided appropriate care. The survey, available in English or Spanish, queried patients/families of any communication with their primary care practitioner (PCP) prior to presentation to the PED, whether patients/families knew if their primary practitioner had an 'On-Call' Service, and whether the patients/families believed their presenting complaint was truly an emergency or life-threatening. The survey also looked into patient demographics including the setting in which the patients saw their primary care practitioner. Trauma-related complaints were excluded. 146 surveys were completed from May to October of 2011. 99% (145/146) of the subjects were discharged home after their evaluation in the PED. 71% (104/146) of the subjects reported not calling their primary care practitioner prior to coming to the PED. However, there was a large difference in those who did not call their primary care provider based on language (66% of English surveys vs. 83% of Spanish surveys). Within that group, 58% (61/104) reported not knowing of a primary care practitioner 'On-Call' when a system existed. Only 29% of Spanish speaking subjects knew of the 'On-Call' Service. Of those not knowing of the 'On-Call' Service, 62% (38/61) reported they would have called their primary care practitioner before presenting to the PED had they been aware of that service. 28% (42/146) of all subjects reported calling their primary care practitioner before coming to the PED; 42% did not wait for someone to call back. Of all subjects, 59% (86/146) saw their primary care practitioner in a Clinic Setting and 33%(86/146) of the subjects saw their primary care practitioner in a Private Pediatric office and/or Group. 52% (77/146) of all subjects expressed concern that their child's illness could be life-threatening. We identified barriers to continuity of care by a primary care practitioner for patients/families who present to the PED as language, lack of knowledge of the 'On-Call' Service, perception of a 'True Medical Emergency', and the Clinic setting. Educating families about 'On- Call' services may decrease PED utilization for non-emergent complaints.
Notes	"Submitted in Partial Fulfillment of the Requirements for the Degree of Master of Arts in Biomolecular Sciences."; Thesis advisor: Cheryl Watson.; M.A.,Central Connecticut State University,,2012.; Includes bibliographical references (leave 42).
Subject	Pediatric emergency services. Pediatric clinics. Thesis 2292
Software	System requirements: PC and World Wide Web browser.
Language	eng
Date of Publication	2012.
OCLC number	829701691
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Non-Emergent Presentations to a children's emergency department : Are Identifiable Barriers to Continuity of Care a Contributing Factor?

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