240 Evaluating the Impact of Limited English Proficiency on Care Delivery in a Pediatric Emergency Department

Objectives. Previous studies in pediatric emergency departments (EDs) showed patients with limited English proficiency (LEP) had gaps in care compared with English-speaking patients. In 2010, the Joint Commission released patient-centered communication standards addressing these gaps. We evaluate the current care of LEP patients in the Children’s Healthcare of Atlanta (CHOA) EDs. Methods. This was a retrospective cohort study of patients <18 years that presented to our EDs in 2016. Length of stay (LOS), change in triage status, return-visit rates, and hospital disposition were compared between patients who requested an interpreter and those who did not. Results. The population included 152,945 patients from 232,787 ED encounters in 2016. Interpreters were requested for 12.1% of encounters. For ED LOS, a model-adjusted difference of 0.77% was found between interpreter groups. For change in triage status, adjusted odds were 7% higher in the interpreter requested cohort. For ED readmission within 7 days, adjusted odds were 3% higher in the interpreter requested cohort. These effect sizes are small (ES < 0.2). Conclusions. Our study showed low ES of the differences in ED metrics between LEP and English-speaking patients, suggesting little clinical difference between the two groups. The impact of this improvement should be further studied.

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The Impact of a Pediatric Emergency Department Facility Verification System on Pediatric Mortality Rates in Arizona

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2017.02.011 ◽

2017 ◽

Vol 52 (6) ◽

pp. 894-901 ◽

Cited By ~ 10

Author(s):

Amber Rice ◽

Jennifer Dudek ◽

Toni Gross ◽

Tomi St Mars ◽

Dale Woolridge

Keyword(s):

Emergency Department ◽

Mortality Rates ◽

Pediatric Emergency ◽

Pediatric Emergency Department ◽

Verification System ◽

The Impact

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The Waiting Room Assessment to Virtual Emergency Department pathway: Initiating video-based telemedicine in the pediatric emergency department

Journal of Telemedicine and Telecare ◽

10.1177/1357633x211044038 ◽

2021 ◽

pp. 1357633X2110440

Author(s):

Esli Osmanlliu ◽

Isabelle Gagnon ◽

Saskia Weber ◽

Chi Quan Bach ◽

Jennifer Turnbull ◽

...

Keyword(s):

Emergency Department ◽

Care Delivery ◽

Care Pathway ◽

Clinical Pathways ◽

A Priori ◽

Pediatric Emergency ◽

Pediatric Emergency Department ◽

Pilot Phase ◽

Waiting Room ◽

Hospital Pediatric

The COVID-19 pandemic has presented pediatric emergency departments with unique challenges, resulting in a heightened demand for adapted clinical pathways. In response to this need, the Montreal Children's Hospital pediatric emergency department introduced the WAVE (Waiting Room Assessment to Virtual Emergency Department) pathway, a video-based telemedicine pathway for selected non-critical patients, aiming to reduce safety issues related to emergency department overcrowding, while providing timely care to all children presenting and registering at our emergency department. The objective of the WAVE pilot phase was to evaluate the feasibility and acceptability of telemedicine in our pediatric emergency department, which was previously unfamiliar with this mode of care delivery. During the six-week, three-evening per week deployment, we conducted 18 five-hour telemedicine shifts. In total, 27 patients participated in the WAVE pathway. Results from this pilot phase met four of five a priori feasibility and acceptability criteria. Overall, participating families were satisfied with this novel care pathway and reported no disruptive technological barriers.

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