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

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.

scholarly journals Decreasing the Time to Oral Antibiotics in a University Hospital Pediatric Emergency Department

2017 ◽  
Vol 22 (4) ◽  
pp. 272-275
Author(s):  
R. Zachary Thompson ◽  
Brian Gardner ◽  
Thomas Carter ◽  
Aric Schadler ◽  
Joye Allen ◽  
...  
Keyword(s):  
Emergency Department ◽  
Medical Center ◽  
Academic Medical Center ◽  
Medication Administration ◽  
Pediatric Emergency ◽  
University Hospital ◽  
Pediatric Emergency Department ◽  
Oral Antibiotics ◽  
Time Period ◽  
Hospital Pediatric

OBJECTIVES To compare time to administration of oral antibiotics in the pediatric emergency department (ED) when antibiotics are stored in the pediatric ED versus when they were dispensed by central pharmacy services within an academic medical center. METHODS This was a retrospective review of patients who received a one-time dose of oral antibiotics within the pediatric ED and were subsequently discharged home. Two 3-month time periods were compared to determine the metrics of providing oral antibiotics before and after these medications were stocked in the pediatric ED automated dispensing cabinet (ADC). The primary outcome was to compare the time to administration. Secondary outcomes were to assess wastage of stocked medications and time to ED discharge. RESULTS In the ADC time period (n = 74), the median time to administration was 17.5 minutes versus 57 minutes in the central pharmacy time period (n = 34) (p < 0.001). The ED length of stay during the ADC time period was 188.5 minutes versus 228.5 minutes (p = 0.094). 35.4% of doses from the ADC expired resulting in a wholesale acquisition cost of $53.14 wasted. CONCLUSION Stocking commonly used oral antibiotics in the pediatric ED led to a significant decrease in the time to medication administration. This decreased time to administration has the potential to lead to improved patient and nursing satisfaction. Routine surveillance is needed after implementation to ensure compliance and to minimize wastage.

THE CURRENT PREVALENCE OF GONOCOCCAL INFECTIONS IN CHILDREN

PEDIATRICS ◽  
1967 ◽  
Vol 39 (3) ◽  
pp. 372-377
Author(s):  
Lawrence F. Nazarian
Keyword(s):  
Emergency Department ◽  
Young Child ◽  
Pediatric Emergency ◽  
Sexual Contact ◽  
Memorial Hospital ◽  
Pediatric Emergency Department ◽  
Young Girls ◽  
Current Prevalence ◽  
Hospital Pediatric ◽  
Genitourinary Infection

In one 6-month period, nine children, ages 11 months through 14 years, presented with gonococcal infections to the Strong Memorial Hospital Pediatric Emergency Department. These patients included young girls with vaginitis whose mothers had gonorrhea and a 10-year-old boy whose sexual contact was a 9-year-old girl. Gonorrhea in children is increasing and takes the form of conjunctivitis, arthritis, or genitourinary infection. The infection seems to be transmitted most often by contamination in the infant, involuntary sexual contact in the young child, and voluntary sexual contact in the older but not necessarily pubescent child. The physician treating children must be aware of the prevalence and characteristics of this type of infection and should use his influence in a preventive manner as well.

scholarly journals Using Queue Theory and Load-Leveling Principles to Identify a Simple Metric for Resource Planning in a Pediatric Emergency Department

2021 ◽  
Vol 8 ◽  
pp. 2333794X2094466
Author(s):  
Jennifer M. Loso ◽  
Stephanie L. Filipp ◽  
Matthew J. Gurka ◽  
Michael K. Davis
Keyword(s):  
Emergency Department ◽  
Human Resource ◽  
Resource Planning ◽  
Pediatric Emergency ◽  
Time Of Day ◽  
Pediatric Emergency Department ◽  
Waiting Room ◽  
Resource Requirements ◽  
Queue Theory ◽  
Load Leveling

Increased waiting time in pediatric emergency departments is a well-recognized and complex problem in a resource-limited US health care system. Efforts to reduce emergency department wait times include modeling arrival rates, acuity, process flow, and human resource requirements. The aim of this study was to investigate queue theory and load-leveling principles to model arrival rates and to identify a simple metric for assisting with determination of optimal physical space and human resource requirements. We discovered that pediatric emergency department arrival rates vary based on time of day, day of the week, and month of the year in a predictable pattern and that the hourly change in pediatric emergency department waiting room census may be useful as a simple metric to identify target times for shifting resources to better match supply and demand at no additional cost.

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