Parental Perception of Waiting Time and its Influence on Parental Satisfaction in an Urban Pediatric Emergency Department: Are Parents Accurate in Determining Waiting Time?

Background Overcrowding in the emergency departments has become an increasingly significant problem. Patient triage strategies are acknowledged to help clinicians manage patient flow and reduce patients’ waiting time. However, electronic patient triage systems are not developed so that they comply with clinicians’ workflow. Objective This case study presents the development of a patient prioritization tool (PPT) and of the related patient prioritization algorithm (PPA) for a pediatric emergency department (PED), relying on a human-centered design process. Methods We followed a human-centered design process, wherein we (1) performed a work system analysis through observations and interviews in an academic hospital’s PED; (2) deduced design specifications; (3) designed a mock PPT and the related PPA; and (4) performed user testing to assess the intuitiveness of the icons, the effectiveness in communicating patient priority, the fit between the prioritization model implemented and the participants’ prioritization rules, and the participants’ satisfaction. Results The workflow analysis identified that the PPT interface should meet the needs of physicians and nurses, represent the stages of patient care, and contain patient information such as waiting time, test status (eg, prescribed, in progress), age, and a suggestion for prioritization. The mock-up developed gives the status of patients progressing through the PED; a strip represents the patient and the patient’s characteristics, including a delay indicator that compares the patient’s waiting time to the average waiting time of patients with a comparable reason for emergency. User tests revealed issues with icon intuitiveness, information gaps, and possible refinements in the prioritization algorithm. Conclusions The results of the user tests have led to modifications to improve the usability and usefulness of the PPT and its PPA. We discuss the value of integrating human factors into the design process for a PPT for PED. The PPT/PPA has been developed and installed in Lille University Hospital's PED. Studies are carried out to evaluate the use and impact of this tool on clinicians’ situation awareness and prioritization-related cognitive load, prioritization of patients, waiting time, and patients’ experience.

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Reducing patient waiting time and length of stay in an Acute Care Pediatric Emergency Department

BMJ Quality Improvement Reports ◽

10.1136/bmjquality.u212356.w7916 ◽

2017 ◽

Vol 6 (1) ◽

pp. u212356.w7916 ◽

Cited By ~ 3

Author(s):

Milfi Al-Onazi ◽

Ahmed Al Hajri ◽

Angela Caswell ◽

Maria Leizl Hugo Villanueva ◽

Zuhair Mohammed ◽

...

Keyword(s):

Emergency Department ◽

Length Of Stay ◽

Acute Care ◽

Waiting Time ◽

Pediatric Emergency ◽

Pediatric Emergency Department ◽

Patient Waiting Time ◽

Patient Waiting

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Parents' willingness to have their child receive care by physician assistants in a pediatric emergency department

CJEM ◽

10.2310/8000.2013.130745 ◽

2013 ◽

Vol 15 (06) ◽

pp. 330-336 ◽

Cited By ~ 2

Author(s):

Quynh Doan ◽

Sam Sheps ◽

Hubert Wong ◽

Joel Singer ◽

David Johnson ◽

...

Keyword(s):

Emergency Department ◽

Waiting Time ◽

Physician Assistants ◽

Pediatric Emergency ◽

Scope Of Practice ◽

Pediatric Emergency Department ◽

Small Minority ◽

Time Reduction ◽

Receive Treatment ◽

To Receive

ABSTRACTObjective:To determine the willingness of parents of children visiting a pediatric emergency department to have a physician assistant (PA) assess and treat their child and the waiting time reduction sufficient for them to choose to receive treatment by a PA rather than wait for a physician.Method:After describing the training and scope of practice of PAs, we asked caregivers of children triaged as urgent to nonurgent if they would be willing to have their child assessed and treated by a PA on that visit: definitely, maybe, or never. We also asked the minimum amount of waiting time reduction they would want to see before choosing to receive treatment by a PA rather than wait for a physician.Result:We approached 320 eligible subjects, and 273 (85.3%) consented to participate. Regarding whether they would be willing to have their child receive treatment by a PA, 140 (51.3%) respondents answered definitely, 107 (39.2%) said maybe, and 26 (9.2%) said never. Most respondents (64.1%) would choose to have their child seen by a PA instead of waiting for a physician if the waiting time reduction were at least 60 minutes (median 60 minutes [interquartile range 60 minutes]). Respondents' perception of the severity of their child's condition was associated with unwillingness to receive treatment by a PA, whereas child's age, presenting complaint, and actual waiting time were not.Conclusion:Only a small minority of parents of children visiting a pediatric emergency department for urgent to nonurgent issues are unwilling to have their child treated by PAs.

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The Impact of a Brief Expectation Survey on Parental Satisfaction in the Pediatric Emergency Department

Academic Emergency Medicine ◽

10.1197/j.aem.2006.06.059 ◽

2006 ◽

Vol 13 (12) ◽

pp. 1280-1287 ◽

Cited By ~ 5

Author(s):

Christopher D. Spahr ◽

Nick A. Flugstad ◽

David C. Brousseau

Keyword(s):

Emergency Department ◽

Pediatric Emergency ◽

Parental Satisfaction ◽

Pediatric Emergency Department ◽

The Impact

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Applying a Human-Centered Design to Develop a Patient Prioritization Tool for a Pediatric Emergency Department: Detailed Case Study of First Iterations (Preprint)

10.2196/preprints.18427 ◽

2020 ◽

Author(s):

Jessica Schiro ◽

Sylvia Pelayo ◽

Alain Martinot ◽

François Dubos ◽

Marie-Catherine Beuscart-Zéphir ◽

...

Keyword(s):

Emergency Department ◽

Design Process ◽

Waiting Time ◽

Situation Awareness ◽

System Analysis ◽

Pediatric Emergency ◽

Pediatric Emergency Department ◽

Human Centered Design ◽

Patient Prioritization

BACKGROUND Overcrowding in the emergency departments has become an increasingly significant problem. Patient triage strategies are acknowledged to help clinicians manage patient flow and reduce patients’ waiting time. However, electronic patient triage systems are not developed so that they comply with clinicians’ workflow. OBJECTIVE This case study presents the development of a patient prioritization tool (PPT) and of the related patient prioritization algorithm (PPA) for a pediatric emergency department (PED), relying on a human-centered design process. METHODS We followed a human-centered design process, wherein we (1) performed a work system analysis through observations and interviews in an academic hospital’s PED; (2) deduced design specifications; (3) designed a mock PPT and the related PPA; and (4) performed user testing to assess the intuitiveness of the icons, the effectiveness in communicating patient priority, the fit between the prioritization model implemented and the participants’ prioritization rules, and the participants’ satisfaction. RESULTS The workflow analysis identified that the PPT interface should meet the needs of physicians and nurses, represent the stages of patient care, and contain patient information such as waiting time, test status (eg, prescribed, in progress), age, and a suggestion for prioritization. The mock-up developed gives the status of patients progressing through the PED; a strip represents the patient and the patient’s characteristics, including a delay indicator that compares the patient’s waiting time to the average waiting time of patients with a comparable reason for emergency. User tests revealed issues with icon intuitiveness, information gaps, and possible refinements in the prioritization algorithm. CONCLUSIONS The results of the user tests have led to modifications to improve the usability and usefulness of the PPT and its PPA. We discuss the value of integrating human factors into the design process for a PPT for PED. The PPT/PPA has been developed and installed in Lille University Hospital's PED. Studies are carried out to evaluate the use and impact of this tool on clinicians’ situation awareness and prioritization-related cognitive load, prioritization of patients, waiting time, and patients’ experience.

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Family members’ satisfaction with the care flow in the Pediatric Emergency Department

Revista Brasileira de Enfermagem ◽

10.1590/0034-7167-2018-0388 ◽

2019 ◽

Vol 72 (2) ◽

pp. 435-441

Author(s):

Giselle Pinto de Oliveira Sá Macedo ◽

Maria D’Innocenzo

Keyword(s):

Emergency Department ◽

Waiting Time ◽

Family Members ◽

Pediatric Emergency ◽

Pediatric Emergency Department ◽

Cross Sectional ◽

Satisfaction Index ◽

Patient Screening ◽

Satisfaction Evaluation

ABSTRACT Objective: To evaluate the satisfaction index of the pediatric patient’s caregiver (person responsible for the child) regarding the waiting time for the care flow in an emergency service. Method: A prospective, cross-sectional, quantitative study with 300 family members in the Pediatric Emergency Department of a general hospital. An instrument was used to analyze the service flow, waiting time and satisfaction evaluation. Descriptive statistical analysis was performed. Results: The satisfaction index of caregivers was statistically significant (p<0.05) the lower was the waiting time for patient screening, care by the doctors and for receiving the prescribed medication. Caregivers who took their children to the emergency department because of the disease (p -0.029) or because they did not find doctors in other hospitals (p-0.021) were satisfied with the waiting time for this service. Conclusion: The quality of care is evaluated as satisfactory by caregivers when children are treated quickly in the Pediatric Emergency Department.

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