Department of Pediatrics, Klinikum Dritter Orden, Munich, Germany
Department of Emergency Medicine, Inselspital, University Hospital, Bern, Switzerland.
Emerg Med J. 2021 Aug;38(8):617-623. doi: 10.1136/emermed-2019-208616. Epub 2020 Dec 21.
Patient numbers in paediatric emergency departments (PED) are steadily increasing. Parental perception of waiting time and reasons for attending a PED with non-emergencies have been investigated in the UK, Australia, Korea, Canada and the USA. We sought to examine which factors influence parental satisfaction with waiting time in a tertiary Swiss PED and whether these differed from other countries.
Paper surveys were administered to parents of children presenting to our interdisciplinary PED from February to May 2015. Primary outcome was parental satisfaction with waiting time, secondary outcomes were satisfaction with treatment, parental reasons for presentation with non-emergencies, parental perception of times to triage, first physician contact and disposition from ED, level of physician training, understanding of various anticrowding strategies and comparison of perceived and true waiting times to triage and physician contact.
739 out of 750 surveys were returned (57 complete, 298 with 1 or 2 missing answers). Satisfaction with waiting time (on a 5-point-Likert-scale; 1 being the best possible answer) was higher in groups with shorter waiting time until triage (+0.41, p=0.001), first physician contact (+1.43, p<0.001) and discharge (+0.71, p<0.001), higher triage category urgency (+0.47, p=0.044) and available entertainment (+0.82, p<0.001). Early first physician contact (+0.33, p=0.008) and time to discharge less than 4 hours (+0.37, p<0.001) was associated with greater satisfaction with treatment (p<0.05). The most frequent reasons for presentation were parental impression that the child had an emergency (n=265, 35.9%) and referral by the family doctor (n=245, 33.2%).
To counteract parental dissatisfaction associated with waiting time, we suggest the implementation of feasible measures including entertainment while waiting, early first medical review and timely discharge from the PED.
儿科急诊部（PED）的就诊人数稳步增加。英国、澳大利亚、韩国、加拿大和美国已经调查了父母对等待时间的看法以及非紧急情况就诊 PED 的原因。我们试图研究哪些因素会影响瑞士一家三级 PED 中父母对等待时间的满意度，以及这些因素是否与其他国家不同。
2015 年 2 月至 5 月期间，我们向在我们的跨学科 PED 就诊的儿童的父母发放纸质调查问卷。主要结果是父母对等待时间的满意度，次要结果是对治疗的满意度、父母因非紧急情况就诊的原因、父母对分诊、首次医生接触和从 ED 处置的时间的看法、医生培训水平、对各种防拥挤策略的理解以及比较感知和真实的分诊和医生接触的等待时间。
750 份调查问卷中，739 份（57 份完整，298 份有 1 或 2 个答案缺失）被收回。在分诊等待时间较短（+0.41，p=0.001）、首次医生接触（+1.43，p<0.001）和出院（+0.71，p<0.001）的组中，等待时间的满意度（在 5 分李克特量表上；1 是最佳可能答案）较高，较高的分诊类别紧急程度（+0.47，p=0.044）和可用娱乐设施（+0.82，p<0.001）。早期的首次医生接触（+0.33，p=0.008）和 4 小时内出院时间（+0.37，p<0.001）与治疗满意度更高相关（p<0.05）。就诊的最常见原因是父母认为孩子有紧急情况（n=265，35.9%）和家庭医生转诊（n=245，33.2%）。
为了应对与等待时间相关的父母不满，我们建议实施可行的措施，包括等待时的娱乐、早期的首次医疗审查和及时从 PED 出院。
