Keijzers Gerben, Crilly Julia, Walters Benjamin, Crawford Rosalind, Bell Christa
Emergency Department, Gold Coast Hospital, Queensland, Australia.
Pediatr Emerg Care. 2010 Apr;26(4):274-80. doi: 10.1097/pec.0b013e3181d6da2c.
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.
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.
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.
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.
评估一种专门的、流动式的、针对儿科患者的护理模式对急诊科（ED）候诊时间、家长满意度及护理转接的影响。
于2007年7月16日至8月12日进行了一项前瞻性观察研究。采用前后对照设计，有为期2周的干预前阶段和为期2周的干预组。在干预期，引入了儿科急诊科倡议（PEDI）团队，该团队由一名流动医生和一名护士组成，具备诊治儿科患者的能力。在患者/家长出院7至14天后通过电话随访其满意度和候诊时间。
分析了453例儿科就诊病例（干预前组216例，干预组237例），其中PEDI团队在干预期诊治了81例儿科患者。干预组在急诊科的住院时间显著缩短（158分钟对194分钟；P = 0.01）。然而，看医生的等待时间并无差异（80分钟对78分钟；P = 0.54）。整个研究组的满意度与工作人员态度及对等待的理解显著相关。
在急诊科工作量高峰时段专门诊治儿科患者的团队可缩短儿科就诊患者在急诊科的总住院时间，但对看医生的等待时间无影响。PEDI团队对护理转接和满意度指标仅有微弱影响。候诊时间、工作人员态度及患者教育被证明是整个研究组总体满意度的重要决定因素。
