Pediatric Emergency Department and Primary Care Provider Attitudes on Assessing Childhood Adversity

2019 ◽  
Vol 35 (8) ◽  
pp. 527-532
Author(s):  
Samantha Schilling ◽  
Ashlee Murray ◽  
Cynthia J. Mollen ◽  
Tara Wedin ◽  
Joel A. Fein ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Care Provider ◽  
Primary Care Provider ◽  
Childhood Adversity ◽  
Pediatric Emergency ◽  
Pediatric Emergency Department ◽  
Provider Attitudes

scholarly journals Adjacent Primary Care May Reduce Less Urgent Pediatric Emergency Department Visits

2020 ◽  
Vol 11 ◽  
pp. 215013272092627
Author(s):  
Julia Ellbrant ◽  
Jonas Åkeson ◽  
Helena Sletten ◽  
Jenny Eckner ◽  
Pia Karlsland Åkeson
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Patient Characteristics ◽  
Pediatric Emergency ◽  
Emergency Department Visits ◽  
University Hospital ◽  
Pediatric Emergency Department ◽  
Hospital Data ◽  
Cross Sectional ◽  
Ed Visits

Aims: Pediatric emergency department (ED) overcrowding is a challenge. This study was designed to evaluate if a hospital-integrated primary care unit (HPCU) reduces less urgent visits at a pediatric ED. Methods: This retrospective cross-sectional study was carried out at a university hospital in Sweden, where the HPCU, open outside office hours, had been integrated next to the ED. Children seeking ED care during 4-week high- and low-load study periods before (2012) and after (2015) implementation of the HPCU were included. Information on patient characteristics, ED management, and length of ED stay was obtained from hospital data registers. Results: In total, 3216 and 3074 ED patient visits were recorded in 2012 and 2015, respectively. During opening hours of the HPCU, the proportions of pediatric ED visits (28% lower; P < .001), visits in the lowest triage group (36% lower; P < .001), patients presenting with fever ( P = .001) or ear pain ( P < .001), and nonadmitted ED patients ( P = .033), were significantly lower in 2015 than in 2012, whereas the proportion of infants ≤3 months was higher in 2015 ( P < .001). Conclusions: By enabling adjacent management of less urgent pediatric patients at adequate lower levels of medical care, implementation of a HPCU outside office hours may contribute to fewer and more appropriate pediatric ED visits.

scholarly journals Community Primary Care Provider Preferences for Emergency Department Follow-up Recommendations

2017 ◽  
Vol 33 (10) ◽  
pp. 690-693
Author(s):  
Marissa A. Hendrickson ◽  
Eta Obeya ◽  
Andrew R. Wey ◽  
Philippe R. Gaillard
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Care Provider ◽  
Primary Care Provider

scholarly journals Guideline Adherence and Antibiotic Utilization by Community Pediatricians, Private Urgent Care Centers, and a Pediatric Emergency Department

2019 ◽  
Vol 59 (1) ◽  
pp. 21-30 ◽  
Author(s):  
Shamim Islam ◽  
Mary Kathryn Mannix ◽  
Ryan K. Breuer ◽  
Amanda B. Hassinger
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
New York ◽  
Otitis Media ◽  
Pediatric Emergency ◽  
Urgent Care ◽  
Medical Society ◽  
Pediatric Emergency Department ◽  
Antibiotic Utilization ◽  
Urgent Care Centers

Pediatric antibiotic prescriptions originate from an increasingly broad range of ambulatory settings. In this retrospective study, pharyngitis, otitis media, sinusitis, pneumonia, and upper respiratory infection cases, at 11 primary care offices, 2 independent urgent care centers (UCCs), and a pediatric emergency department in Western New York, were analyzed relative to medical society practice guidelines and antibiotic utilization. Of 2358 eligible visits across all sites, 25% were for study diagnoses, with 38% at UCC ( P < .01). Across all sites, 26% of pharyngitis cases given antibiotics did not have diagnostic evidence of bacterial infection. At primary care offices and UCCs, guideline recommended first-line agents for pharyngitis and otitis media were used in only 58% and 63% of treated cases, respectively. Overall, an estimated 9855 to 12 045 avoidable antibiotic and 8030 non-guideline antibiotic courses annually are represented by the 14 sites studied. These and other study findings highlight numerous opportunities for outpatient pediatric antibiotic stewardship.

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