Emergency Department Quality Assurance/Improvement Practices for the Pediatric Patient

Abstract

Study objective: To describe emergency department quality assurance (QA)/improvement (QI) practices for pediatric patients. Design: Mail survey of a cohort of emergency physicians. Participants: Pediatric Section members of the American College of Emergency Physicians and a computer-generated random sample of general ACEP members. Results: Pediatric Section and general ACEP physicians were mailed a 13-question QA survey. Of the 500 surveys distributed, 207 (41.4%) were returned. Three emergency care settings for pediatric patients seen in the ED were identified: (1) children's hospital ED (14%), (2) general ED with a separate area designated for the evaluation of pediatric patients (12%), and (3) general ED where pediatric and adult patients are evaluated in the same area (74%). Separate QA indicators were used to monitor care of the pediatric patients seen in the ED by 61% of the respondents; 39% used "adult" indicators only. High pediatric census was associated with pediatric representation on the ED QA/QI Committee, the use of separate pediatric indicators to monitor care of pediatric patients in the ED, the separation of pediatric and adult patient care areas and satisfaction with the respondent's ED QA/QI plan. Conclusion: The bulk of pediatric emergency patients are cared for in a general ED. Most ACEP members surveyed reported the use of separate QA indicators to monitor the care of pediatric patients seen in the ED. This survey provides the first description of QA/QI practices for pediatric patients by EDs nationwide. [Gausche M, Rutherford M, Lewis RL: Emergency department quality assurance/improvement practices for the pediatric patient. Ann Emerg Med June 1995;25:804-808.]