Emergency review clinic: impact on paediatric admissions

Abstract

Background: Inappropriate or unnecessary paediatric inpatient admissions are sometimes unavoidable but are costly and increase pressure on services. Various measures, including paediatric observation units, have been undertaken in an attempt to reduce these admissions.

Aims: We established an emergency review clinic to assess whether we could reduce admission rates by giving carefully selected children follow-up ED review appointments.

Methods: An emergency review clinic was run in the paediatric room of the Emergency Department by a senior paediatric registrar during the hours 10 a.m. to 12 midday, Monday to Friday inclusive. Patients were booked into this review clinic from ED. Data relating to paediatric admissions in the years prior to and after the institution of the review clinic were analysed.

Results: A significant reduction (p < 0.0001) was noted in the paediatric inpatient admission rates following establishment of the review clinic.

Conclusions: A paediatric emergency review clinic can significantly reduce unnecessary or inappropriate admissions but more research is needed to quantitatively characterise parent/patient satisfaction in this regard.

Keywords: Emergency department; Pediatric admissions; Pediatrics.