Abram Evan, Dhaliwal Bhavan, Oketola Banke, Badran Hoda, Gangwani Apoorva, Eleonu Peace, Costello Carrie, Tam Clara, Klassen Terry P, Doyle Elisabete, Aregbesola Alex
The Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.
Department of Pediatrics and Child Health, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
CJEM. 2025 Apr 18. doi: 10.1007/s43678-025-00897-3.
The primary objective of the project was to summarize existing evidence on patient experiences in pediatric emergency departments (EDs). The secondary objectives were to characterize patient care experience in pediatric EDs, identify barriers to optimal patient care in pediatric EDs, and identify equity, diversity, and inclusion (EDI) principles influencing pediatric emergency care.
We performed a systematic review of cohort, cross-sectional, and controlled clinical studies on children's (≤ 21 years) experience in the pediatric ED. We searched MEDLINE (Ovid), Embase (Ovid), PsycInfo (Ovid), Cochrane Database of Systematic Reviews (Ovid), CENTRAL (Ovid), and CINAHL (EBSCO) from inception until September 7, 2023. Two reviewers independently screened articles for primary outcomes involving any health care outcome or health care utilization, along with secondary outcomes of EDI factors influencing patient care. Data were obtained from included studies using narrative and descriptive analysis. The process was strengthened by input from patients, families, and providers on the Manitoba Emergency Advisory Committee, who proposed additional areas for consideration.
Six articles were included, assessing 12 experiences. All studies were from high-volume centers. The primary outcome data indicated an overall satisfaction being rated positively, with satisfaction levels exceeding 70% despite lower ratings in privacy, communication, and waiting areas. Wait times and speed of care were significantly correlated with satisfaction (r = -0.48, P < 0.01 and r = 0.38, P < 0.01, respectively), noting wait times and privacy as barriers to care. The EDI factor impacting patient experience was race, showing decreased scores for privacy and patient voice for those identifying as non-white.
Even with a high overall satisfaction in the pediatric EDs, aspects influencing the experience can be improved. Wait times, waiting areas, privacy and EDI factor such as race should be addressed to help overcome barriers and improve the care patients receive.
该项目的主要目标是总结关于儿科急诊科患者体验的现有证据。次要目标是描述儿科急诊科的患者护理体验，确定儿科急诊科提供最佳患者护理的障碍，并确定影响儿科急诊护理的公平、多样性和包容性（EDI）原则。
我们对关于儿童（≤21岁）在儿科急诊科体验的队列研究、横断面研究和对照临床研究进行了系统综述。我们检索了MEDLINE（Ovid）、Embase（Ovid）、PsycInfo（Ovid）、Cochrane系统评价数据库（Ovid）、CENTRAL（Ovid）和CINAHL（EBSCO），检索时间从各数据库建库至2023年9月7日。两名评审员独立筛选文章，以获取涉及任何医疗保健结果或医疗保健利用情况的主要结果，以及影响患者护理的EDI因素的次要结果。使用叙述性和描述性分析从纳入的研究中获取数据。曼尼托巴省急诊咨询委员会的患者、家属和提供者提供了意见，加强了这一过程，他们提出了其他需要考虑的领域。
纳入了6篇文章，评估了12种体验。所有研究均来自大型中心。主要结果数据表明总体满意度得到了积极评价，尽管在隐私、沟通和候诊区的评分较低，但满意度仍超过70%。等待时间和护理速度与满意度显著相关（分别为r = -0.48，P < 0.01和r = 0.38，P < 0.01），指出等待时间和隐私是护理的障碍。影响患者体验的EDI因素是种族，对于那些自认为是非白人的患者，隐私和患者话语权得分较低。
即使儿科急诊科总体满意度较高，影响体验的各个方面仍可得到改善。应解决等待时间、候诊区、隐私以及种族等EDI因素，以帮助克服障碍，改善患者接受的护理。
