Abstract:
BACKGROUND:The use of pediatric hospitalists in community hospitals has increased over the past decade in response to the desire to provide high-quality pediatric care. Many hospitals are challenged to create financially independent and productive programs. OBJECTIVE:To evaluate an alternative approach to traditional community hospital pediatric care of having pediatricians work in a combined pediatric Emergency Department (PED)/inpatient unit. DESIGN/METHODS:Franklin Square Hospital Center converted its pediatric hospitalist program from a traditional inpatient with partial Emergency Department (ED) coverage program to one that covers a combined PED/inpatient unit. Outcome categories were compared between the year before opening, 2003, to the year after, 2004. Measures included total part B billing, overall patient satisfaction scores for the PED and inpatient unit from the Press Ganey patient satisfaction survey, perception of wait times and time to admission, and risk-adjusted inpatient length of stay (ALOS). RESULTS:Part B billings from the 5.5 Full Time Equivalent (FTE) pediatric hospitalists increased 82% from increased 61% from 2003 to 2004, from 1,631,583 dollars in 2003 to 2,967,715 dollars in 2004 as a result of increased volume of ED patients seen by pediatricians. The mean inpatient satisfaction score did not significantly change, 75.7 in 2003 and 79.0 in 2004 (P = 0.432), but the mean PED score significantly increased from 75.8 to 83.4 (P = 0.0001). Mean scores of the efficiency measures on the survey increased for PED patients, with the mean score for wait time to treatment increasing from 62.0 to 75.3 (P < 0.0001). Total throughput time through the ED improved significantly as well from 143 minutes to 122 minutes (P = 0.0003). Risk-adjusted length of stay performance did not change; for calendar year 2003, the mean monthly ALOS was 1.883 (95% range 1.503, 2.263), compared with a 2004 mean monthly ALOS of 1.869 (95% range 1.523, 2.216). CONCLUSIONS:Implementation of a combined PED/inpatient unit was associated with increased billing by hospitalists, increased satisfaction scores of ED patients, and decreased ED throughput times. Pediatric hospitalist programs that want to improve financial and patient outcomes in a community setting could consider adopting the combined unit approach.
journal_name
Pediatr Emerg Carejournal_title
Pediatric emergency careauthors
Krugman SD,Suggs A,Photowala HY,Beck Adoi
10.1097/01.pec.0000248685.94647.01subject
Has Abstractpub_date
2007-01-01 00:00:00pages
33-7issue
1eissn
0749-5161issn
1535-1815pii
00006565-200701000-00009journal_volume
23pub_type
杂志文章abstract:OBJECTIVES:Extrapyramidal symptoms (EPS) induced by pharmacologic agents can cause patient discomfort and lead to emergency department visits. Analyzing these cases at a pediatric emergency department may help to elucidate the characteristic features of extrapyramidal syndrome in children. METHODS:This retrospective s...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001954
更新日期:2020-10-01 00:00:00
abstract::Corn starch powder is widely used for routine infant skin care as a substitute for talcum powder, as it is believed to have fewer respiratory hazards. We describe a one-month-old infant who presented to an emergency department with respiratory failure and a severe pneumonitis from aspiration of corn starch powder. The...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199604000-00011
更新日期:1996-04-01 00:00:00
abstract::Omeprazole; the first proton pump inhibitor (PPI) showing an effective acid inhibitory ability, provides the satisfactory therapy either in gastro-esophageal reflux symptom relief or in healing of erosive esophagitis. It's also effective in peptic ulcer disease. Up to date, omeprazole efficacy and safety are well esta...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000173350.45648.9b
更新日期:2005-08-01 00:00:00
abstract::Many of the causes of complaints can be reduced but not completely eliminated. Appropriate attention through education and quality management keeps the department's attention focused on increasing patient satisfaction. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/00006565-199404000-00009
更新日期:1994-04-01 00:00:00
abstract:INTRODUCTION:Viral gastroenteritis with dehydration is one of the most frequent reasons for visits to pediatric emergency departments (ED). Parental intervention before presentation to the ED can make a significant difference in the course of a child's illness. There is a discrepancy between medical knowledge of dehydr...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/pec.0b013e3181d6d9de
更新日期:2010-04-01 00:00:00
abstract::The most common cause of recurrent rhabdomyolysis in childhood is inherited metabolic disorders. Carnitine palmitoyl transferase II (CPT II) deficiency is a lipidosis and is a common cause of inherited recurrent myoglobinuria. The disease is inherited in autosomal recessive trait, and the clinical phenotype ranges fro...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000127
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVES:This study examined how much parents are willing to pay and/or willing to stay to make their child's intravenous (IV) catheter placement painless. METHODS:A prospective survey was conducted using a questionnaire administered to a consecutive sample of parents presenting to an emergency department (ED). Elig...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000238743.96606.69
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:A brief resolved unexplained event (BRUE) in infancy is a common reason for visiting the emergency department. However, little is known about the long-term outcomes of such an event. This study evaluates future mortality, morbidity, and/or developmental outcome after a BRUE. METHODS:A single-center retrospec...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001816
更新日期:2019-11-01 00:00:00
abstract::A case history of a young girl who sustained a small posterior laceration of her cervical trachea after blunt trauma is presented. She was brought to the emergency department (ED) by her parents roughly two hours after the incident with only minor symptoms. While in the ED, she developed significant airway compromise ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199110000-00008
更新日期:1991-10-01 00:00:00
abstract:OBJECTIVES:National guidelines for routine pediatric acute asthma care recommend providing corticosteroids, and discourage routinely obtaining chest radiographs (CXRs) and using antibiotics. We examined rates of adherence to all 3 of these aspects during emergency department (ED) visits and compared performance between...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001706
更新日期:2019-01-07 00:00:00
abstract:OBJECTIVES:This study aimed to describe the epidemiology and clinical burden of unintended carbon monoxide (CO) poisoning among children in the Negev region of southern Israel. METHODS:This was a cross-sectional retrospective study of CO poisoning patients admitted to Soroka University Medical Center in 2011 through 2...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001484
更新日期:2020-11-01 00:00:00
abstract::Sudden unexpected infant deaths (SUIDs) are deaths in infants younger than 12 months that occur suddenly, unexpectedly, and without obvious cause in the emergency department (ED). Sudden infant death syndrome, the leading cause of SUID in the United States, is much more common, but fatal child abuse and neglect have b...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/PEC.0b013e31826d1e9a
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:The use of observational units (OUs) in pediatric emergency departments (EDs) has become an important adjunct to emergency care. An extended observation period (4 to 23 hours) in the ED has decreased both the number of admissions and prolonged use of acute ED beds. This serves to increase patient satisfactio...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:
更新日期:2005-03-01 00:00:00
abstract::Foreign body ingestion is a common occurrence in children. Morbidity associated with ingestion is rare and is dependent on the type of foreign body ingested. We report a case of a 9-year-old boy who developed intestinal obstruction and perforation following ingestion of magnetic-backed earrings. ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000134926.03030.a7
更新日期:2004-07-01 00:00:00
abstract:PURPOSE:This study aimed to determine the prevalence of and risk factors for postpartum depression (PPD) in mothers of young infants presenting to the pediatric emergency department (PED). METHODS:This was a prospective, observational study to evaluate the prevalence of PPD in a sample of mothers of young infants pres...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000260
更新日期:2014-11-01 00:00:00
abstract::Unwind or incise has been the standard of management for removing hair tourniquets. The hair ends are usually difficult to hold and unwind as they break at the ends easily, and using scalpels or needles to get under the hair tourniquet is difficult when the involved appendage is swollen and leads to more trauma to the...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31820d65b7
更新日期:2011-03-01 00:00:00
abstract::Although the prevalence of hypertension in the pediatric population is estimated at only 1% to 2%, hypertensive urgencies and emergencies may be encountered in the emergency department. Efficient management of these children is of utmost importance to avoid some of the life-threatening complications associated with hy...
journal_title:Pediatric emergency care
pub_type: 杂志文章,评审
doi:10.1097/01.pec.0000166733.08965.23
更新日期:2005-06-01 00:00:00
abstract::Inadvertent knotting of urethral catheters and enteric feeding tubes is a rare complication in pediatric patients. If a small flexible tube is used and advanced too far, upon withdrawal, the catheter may knot in the bladder. Surgical intervention for retrieval is required in most cases. We present a case of a 26-day-o...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000000751
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:Exclusion of family members (FM) during pediatric procedures in the emergency department (ED) is an accepted practice. This study questions the validity of such a practice. SUBJECTS:FM of ED pediatric patients undergoing procedures and ED staff performing procedures. SITES: ED of a tertiary care university-a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199608000-00008
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:To estimate the prevalence of and to identify factors associated with prolonged emergency department length-of-stay (ED-LOS) for admitted children. METHODS:Data were from the 2001-2006 National Hospital Ambulatory Medical Care Survey. The primary outcome was prolonged ED-LOS (defined as total ED time >8 hour...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31820943e4
更新日期:2011-02-01 00:00:00
abstract::Recent epidemiological studies have shown that childhood back pain is a common complaint often prompting medical attention and that it is infrequently the result of serious etiology. This challenges the traditional view that childhood back pain was an uncommon and ominous symptom, always indicative of significant path...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181f054a9
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:Emergency department (ED) crowding is an increasingly common problem in the United States. Crowding can lead to ED closure and diversion, poor patient satisfaction, and patient safety issues. The purpose of this study was to examine measures of ED census and measures of crowding to determine if a correlation ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318226c7dd
更新日期:2011-08-01 00:00:00
abstract::Sexually transmitted infection as the result of child sexual abuse in prepubertal children is uncommon. Chlamydia trachomatis conjunctivitis is an even less common entity in prepubertal children outside the newborn period. This report details the presentation of 2 children with conjunctivitis who were subsequently dia...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0000000000001449
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:To describe a case series of 4 children who developed acute rhabdomyolysis as a complication of acute respiratory failure secondary to status asthmaticus. METHODS:A retrospective review of all children who were admitted to our pediatric intensive care unit (PICU) with status asthmaticus from November 1998 t...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/01.pec.0000230711.81646.7a
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVES:This study aimed to create and analyze the performance of an automated triage tool alerting triage nursing staff and physicians to an abnormal heart rate consistent with septic shock in a pediatric emergency department. METHODS:A computerized best-practice alert (BPA) triage system corrected heart rate for ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e318267a78a
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Since 1983, no study has evaluated the costs and complications involved in the inpatient evaluation of antibiotic therapy for febrile infants aged 29 to 60 days. METHODS:A prospective quality indicator/quality assurance study of low-risk febrile young infants (FYIs) was conducted during a 16-month period af...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181d1e180
更新日期:2010-03-01 00:00:00
abstract::This article describes a small series of injuries resulting from a new fad activity among children in Baltimore. "Flipping" involves jumping from an elevated surface and executing an aerial flip, with the intent to land upright. Because this activity takes place frequently on hard surfaces such as concrete, injuries o...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/00006565-199304000-00010
更新日期:1993-04-01 00:00:00
abstract::When an emergency medicine physician evaluates a child with abdominal pain and a history of appendectomy, appendicitis is often excluded from the differential. We present a case of a 16-year-old boy who developed stump appendicitis 3 years after laparoscopic appendectomy. Knowledge of this rare phenomenon in children ...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e31827b54db
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVE:To increase the evidence base by characterizing various features of pediatric sports-related abdominal injuries. DESIGN:A review of the trauma database at The Children's Hospital at Westmead was undertaken for all abdominal injuries presenting to the emergency department between 2001 and 2006. SETTING:The C...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181cd7f3f
更新日期:2010-01-01 00:00:00
abstract::Neck pain is a relatively common pediatric complaint. Most is of benign etiology. We present an unusual case of epidural abscess with associated discitis in the cervical spine of a 12-year-old after a dental extraction. This potentially dangerous complication was diagnosed before neurological complications developed a...
journal_title:Pediatric emergency care
pub_type: 杂志文章
doi:10.1097/PEC.0b013e3181c8c60b
更新日期:2009-12-01 00:00:00