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Trends in use in a Canadian pediatric emergency department

Published online by Cambridge University Press:  04 March 2015

Quynh Doan ,
Emerson D. Genuis  and
Alvis Yu
Quynh Doan*
Affiliation:
Division of Pediatric Emergency Medicine, Department of Pediatrics Department of Emergency Medicine
Emerson D. Genuis
Affiliation:
Department of Emergency Medicine
Alvis Yu
Affiliation:
Faculty of Medicine, University of British Columbia, Vancouver, BC
*
B429_4480 Oak Street, Vancouver, BC V6H 3N1; [email protected]

Abstract

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Introduction:

Emergency department (ED) crowding is a significant problem in Canada and has been associated with decreased quality of care in general and pediatric emergency departments (PEDs). Although boarding of admitted patients in the ED is the main contributor to adult ED overcrowding, factors involved in PED crowding may be different. The objective of this study was to report the trend in PED services use and to document the degree of overcrowding experienced in a Canadian PED.

Methods:

A retrospective cohort study was conducted using administrative data from a tertiary care PED from 2002 to 2011. The primary outcome was PED use (total volume of visits and case severity per triage levels using the Canadian Triage and Acuity Scale [CTAS] score and admissions). Secondary outcomes included measures of PED overcrowding, such as rates of patients leaving without being seen (LWBS) and length of stay (LOS).

Results:

Total volumes increased by 30% over the 10-year study period, whereas hospitalizations remained stable at approximately 10%. Trends in CTAS levels did not indicate meaningful changes in the severity of cases treated at our PED. LWBS proportions among CTAS 3, CTAS 4, and CTAS 5 groups and LOS for all CTAS groups progressively and statistically increased from year to year.

Conclusions:

Over the course of the study period, there was a substantial increase in PED visits,which likely contributed to the worsening markers of PED flow outcomes. Further study into the effects of PED crowding on patient outcomes is warranted.

Keywords

cardiopulmonary resuscitationlaryngeal mask airwaypositive pressure ventilation
Type
Original Research • Recherche Originale
Information
Canadian Journal of Emergency Medicine , Volume 16 , Issue 5 , September 2014 , pp. 405 - 410
Copyright
Copyright © Canadian Association of Emergency Physicians 2014

References

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