Pediatric Trauma Experience After Transition to a Freestanding Children's Hospital.

Abstract

Transition of pediatrics services to freestanding children's hospitals is a common trend over the past 3 decades, yet there is no published information on the effect of these moves on the pediatric emergency department (ED). We looked at the effect on trauma volume and severity presenting to the ED after transitioning to a freestanding children's hospital at a location previously without dedicated pediatrics services. We analyzed data using a retrospective chart review of pediatric trauma visits (age, <15 years) from our pediatric trauma registry. Data analyzed included trauma volume per year, injury severity score, method of trauma, and method of arrival to hospital. Patients were differentiated into groups based on premove years (2008-2010) and postmove years (2012-2014). A total of 833 trauma patients were admitted to the ED between 2008 and 2014. Trauma volume per year almost doubled in years after the move. Difference in injury severity score and methods of trauma were not statistically significant. In postmove years, there was an increase in emergency medical service and private vehicle visits. New characteristics and location of the freestanding children's hospital may suggest that easy access to the new location, parental preferences for specialized pediatrics services, and emergency medical service preferences may have positively impacted trauma volume without affecting the severity of trauma seen in our department. This study provides a unique single-center experience in understanding ED patient flow after a major department transition.