Parental use of a paediatric emergency department as an ambulatory care service

Abstract

Objective : This qualitative study explored the parental attitudes, perceptions and beliefs that play a role in the use of a tertiary paediatric emergency department (FED) when a child has a non‐urgent illness. Method : Semi‐structured, in‐depth interviews of 25 parents of children with non‐urgent illnesses were conducted in the waiting room of a tertiary PED in Western Sydney in 1998. Inductive analysis was used to identify dominant themes. Results : Parents used their own system of triage to choose the appropriate service for their sick child. The perceived expertise of the tertiary PED, access and parental expectations all appeared to be major factors in parental use of a PED. Conclusions : The parental choice to attend a PED is a dynamic, complex and unique process and the parental views that underpin this process often diverge from those of health professionals about the most ‘appropriate’ use of a PED. Implications : A clearer understanding by health professionals of the factors influencing parental choice will promote more effective collaboration with parents and ultimately assist in the decision on the best management option for sick children.

Emergency Department Use by Infants Less Than 14 Days of Age

“…Marital status, race, income, parental education level, maternal age, and lack of an alternate source of care are other socioeconomic factors that have been reported to affect ED use. 8,14,15,[22][23][24][25] There is a paucity of similar studies in the neonatal age group. Our study is the first prospective design to focus specifically on socioeconomic factors related to use of the ED by infants less than 14 days of age.…”

Making choices: why parents present to the emergency department for non-urgent care

“…A structured face-to-face interview was based on a modified version of a Canadian survey tool developed and used by Truman and Reutter, and further developed using the emergent themes from Woolfenden and colleagues’ Australian study 2 3. The survey measurement tool was a 43-item questionnaire that contained both fixed-response and open-ended questions about the nature, seriousness and duration of the child’s symptoms; the parent’s at-home treatment of these symptoms; and their attempts to obtain and use professional advice before coming to the PED.…”

Pediatric Emergency Department Overcrowding: Electronic Medical Record for Identification of Frequent, Lower Acuity Visitors. Can We Effectively Identify Patients for Enhanced Resource Utilization?

“…Some have even suggested that patient preferences are the major determinant of use of EDs for lower acuity concerns (1,4). However, on any single encounter, those same characteristics of any individual utilizing the ED for a lower acuity concern are common among many individuals who also utilize EDs for higher acuity, truly emergent concerns (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30). Extended patterns of utilization might be a better predictor and a means for identifying frequent, lower acuity utilizers of emergency services.…”