From the Division of Emergency Medicine, Department of Pediatrics, Hospital for Sick Children.
Pediatr Emerg Care. 2021 Dec 1;37(12):e1321-e1325. doi: 10.1097/PEC.0000000000002031.
Return visits to the pediatric emergency department (ED) give insight into the unmet needs of patients and families. The aim of this study was to capture the parent perspective on factors contributing to return visits to the pediatric ED.
This is a prospective cohort study consisting of an 11-item survey that was administered to parents of children who had a return visit to the ED less than 72 hours from their initial visit. Surveys were distributed over an 8-month period between November 2015 and June 2016.
The primary reason parents report for returning to the ED is that their child had ongoing or worsening symptoms (55%). Parents were satisfied with the care they received at the initial ED visit (89% report excellent, very good or good care). For parents who report that the initial visit could have been improved, they report wanting more tests done (54%), a better follow-up plan arranged by the ED (31%), consultation with a specialist (26%), admission to hospital on the initial visit (26%), and better communication and more time spent with the ED physician (21%). The majority (97%) of parents reported that their child has a primary care provider, and 39% of parents brought their child to a health care provider for the same problem in the 7 days before their return visit to the ED.
The parent perspective gives important insights into the reasons for return visits to the pediatric ED. Conclusions from this study will help inform future quality improvement initiatives that direct health care resources to provide high value care to patients and families.
儿科急诊部（ED）的复诊可深入了解患者和家属的未满足需求。本研究旨在从家长的角度了解导致儿科 ED 复诊的因素。
这是一项前瞻性队列研究，包括对在初始就诊后不到 72 小时内再次到 ED 就诊的儿童的家长进行的 11 项调查。调查在 2015 年 11 月至 2016 年 6 月的 8 个月期间进行。
家长报告再次到 ED 的主要原因是孩子的症状持续或加重（55%）。家长对他们在初始 ED 就诊时接受的护理感到满意（89%报告极好、非常好或好的护理）。对于报告初始就诊可以改进的家长，他们希望进行更多的检查（54%）、ED 安排更好的随访计划（31%）、咨询专家（26%）、初始就诊时住院（26%），以及更好的沟通和与 ED 医生更多的时间（21%）。大多数（97%）家长表示他们的孩子有初级保健提供者，39%的家长在孩子返回 ED 就诊前的 7 天内因同样的问题带孩子去了医疗保健提供者就诊。
家长的观点提供了有关儿科 ED 复诊原因的重要见解。本研究的结论将有助于为未来的质量改进计划提供信息，以便将医疗资源用于为患者和家属提供高价值的护理。
