Does a dedicated pediatric team within a busy mixed emergency department make a difference in waiting times, satisfaction, and care transition?

OBJECTIVES: To evaluate the impact of a dedicated, free-floating, pediatric-targeted care delivery model on emergency department (ED) waiting times, parent satisfaction, and transition of care.

METHODS: A prospective, observational study was conducted between July 16 and August 12, 2007. It incorporated a before-and-after design with a 2-week preintervention and a 2-week intervention group. In the intervention period, the pediatric ED initiative (PEDI) team was introduced, which consisted of a free-floating doctor and nurse equipped to see pediatric patients. Consenting patients/parents were followed up by telephone 7 to 14 days after discharge regarding satisfaction and waiting times.

RESULTS: Four hundred fifty-three pediatric presentations (216 in the preintervention group and 237 in the intervention group) were analyzed, of which the PEDI team treated 81 pediatric patients during the intervention period. The intervention group had a significantly shorter length of stay in the ED (158 vs 194 minutes; P = 0.01). However, there was no difference in time to be seen by a doctor (80 vs 78 minutes; P = 0.54). Satisfaction of the total study group was significantly related to staff attitude and understanding of the wait.

CONCLUSIONS: A dedicated pediatric team that specifically sees and treats pediatric populations during times of peak ED workload can reduce total ED length of stay for pediatric presentations, but has no effect on waiting time to see a doctor. There was only a marginal impact of the PEDI team on both transition of care and satisfaction indicators. Waiting times, staff attitude, and patient education proved to be important determinants of overall satisfaction for the total study group.