PS-345 Reduction Of Paediatric Emergency Hospital Admissions By Modifications In Paediatric Emergency Department Policy

Abstract

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 paediatric 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) maximising the useof the paediatric emergency department observation unit. Objective To evaluate the effect of change in our policy on the admission rate. Methods The effects of this policy on reduction of admission rates for total paediatric admissions and for some selected common paediatric 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 paediatric problems studied. Conclusion A multidisciplinary paediatric emergency department policy, using as much available evidence as possible, was successful in significantly reducing paediatric hospital admissions.