Journal of Emergencies, Trauma, and Shock
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Year : 2013  |  Volume : 6  |  Issue : 3  |  Page : 209-212

Reduction of pediatric emergency hospital admissions by a change in pediatric emergency department policy

1 Consultant of Pediatric Emergency, Aladan Hospital, Kuwait
2 Department of Pediatrics, Faculty of Medicine, Elmansoura University, Egypt

Correspondence Address:
Ahmed F Elhassanien
Department of Pediatrics, Faculty of Medicine, Elmansoura University
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0974-2700.115349

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Background: Reduction in admissions is an important aim of emergency department working policy to overcome the problems of a shortage of inpatient beds, rising costs and exhausted resources. A new policy was instituted in the pediatric emergency department (PED) of a hospital in Kuwait with the following components: (1) assigning senior doctor staff (2) implementation of new disease management guidelines; and (3) maximizing the use of the pediatric emergency department observation unit. Objective: to evaluate the effect of change in our policy on the admission rate. Materials and Methods: The effects of this policy on reduction of admission rates for total pediatric admissions and for some selected common pediatric conditions were prospectively studied over a period of 3 years from institution of the policy and compared with the 3-year period before the policy was instituted. Results: There was a significant reduction in admission rates after institution of the new policy. The proportion of hospital admissions to PED observation unit cases was significantly reduced as a whole from 64.9% ± 5.1% to 33.2 ± 0.6% and also for the common pediatric problems studied. Conclusion: A multidisciplinary pediatric emergency department policy, using as much available evidence as possible, was successful in significantly reducing pediatric hospital admissions.

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