Evaluation of the Pediatric Emergency Department Left Without Treatment Experience

2.50
Hdl Handle:
http://hdl.handle.net/10755/162556
Type:
Presentation
Title:
Evaluation of the Pediatric Emergency Department Left Without Treatment Experience
Abstract:
Evaluation of the Pediatric Emergency Department Left Without Treatment Experience
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Abbott Eckhart, Janet E., RN, MSN, EdD
P.I. Institution Name:Nova Southeastern University
Title:Assistant Professor of Graduate Nursing
Contact Address:147 Evergreen Road, Jonesborough, TN, 37659, USA
Contact Telephone:423-652-6334
Co-Authors:Erin Anne Eckhart, RN, BSN, CCRN
Leadership Conference - Research Abstract: Evaluation of the Pediatric Emergency Department Left Without Treatment Experience

Purpose: The purpose of this study was to evaluate the pediatric left without treatment (LWOT) experience from the parent's perspective, identify rationale for the decision, and develop a plan to reduce LWOT occurrences for this pediatric emergency department (ED). The LWOT occurrence poses primary and secondary threats to the ED. Primary risks include a missed, potentially life-threatening condition or a perceived/actual EMTALA violation. Secondary risks include patient/family dissatisfaction, loss of revenue, and a threat to the organization's market share.

Design: The design was a combined qualitative and quantitative approach, with development and evaluation methodologies utilized, using Queuing theory as the theoretical framework. There were three parts to the evaluation. First was analysis of the ED medical record. Second was evaluation of the parental telephone interviews. Third was development of a correction plan to reduce the LWOT occurrences.

Setting: Setting was the ED of a 258 bed, academic pediatric hospital in the mid-Atlantic region of the United States. The ED was a level I trauma center with an annual volume of 76,000 patients.

Participants/Subjects: Participants were selected from the ED database. Eligibility criteria included all LWOT patients with a telephone number, English speaking and parental contact listed on the medical record. Fifty-one patients/parents met inclusion criteria. Subjects were parents of pediatric LWOT patients because they were the decision makers for the LWOT experience.

Methods: The researcher developed two instruments. Due to researcher's inability to obtain written consent from parents prior to chart audit and telephone interview, the ED performance improvement team completed data collection as a part of the department's quality program. The team summarized all data on an Excel spreadsheet, removing all patient and parent identifiers prior to providing data to researcher for analysis. Researcher applied descriptive and inferential statistical analysis to data using SPSS software. The one-tailed t-test with a p<0.05 was used to determine whether a statistically significant difference existed between actual and perceived wait times for LWOT. A plan to reduce LWOT occurrences was then developed and submitted for departmental approval.

Results/Outcomes: The parents' perceived wait time (119.41 minutes) was significantly longer that actual wait time (87.27 minutes). Researcher identified five general categories of parental dissatisfaction: staff uncaring/indifferent; inadequate explanation of delays; inadequate comfort measures; inadequate food/drink/diapers; excessive wait time; and felt better so left. Ninety-two percent of parents identified 30 minutes as an acceptable wait time.

Implications: Study provided insight into parental decision-making when making the LWOT decision and identified opportunities to reduce the LWOT occurrence. The plan provided specific strategies to reduce the two primary and three secondary risks associated with the LWOT experience: improved patient outcomes, reduced risk for EMTALA violation, improved patient/family satisfaction, increased revenues, and improved market share.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEvaluation of the Pediatric Emergency Department Left Without Treatment Experienceen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162556-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Evaluation of the Pediatric Emergency Department Left Without Treatment Experience</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Abbott Eckhart, Janet E., RN, MSN, EdD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Nova Southeastern University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor of Graduate Nursing</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">147 Evergreen Road, Jonesborough, TN, 37659, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">423-652-6334</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">janeteckhart@prodigy.net</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Erin Anne Eckhart, RN, BSN, CCRN</td></tr><tr><td colspan="2" class="item-abstract">Leadership Conference - Research Abstract: Evaluation of the Pediatric Emergency Department Left Without Treatment Experience<br/><br/>Purpose: The purpose of this study was to evaluate the pediatric left without treatment (LWOT) experience from the parent's perspective, identify rationale for the decision, and develop a plan to reduce LWOT occurrences for this pediatric emergency department (ED). The LWOT occurrence poses primary and secondary threats to the ED. Primary risks include a missed, potentially life-threatening condition or a perceived/actual EMTALA violation. Secondary risks include patient/family dissatisfaction, loss of revenue, and a threat to the organization's market share.<br/><br/>Design: The design was a combined qualitative and quantitative approach, with development and evaluation methodologies utilized, using Queuing theory as the theoretical framework. There were three parts to the evaluation. First was analysis of the ED medical record. Second was evaluation of the parental telephone interviews. Third was development of a correction plan to reduce the LWOT occurrences. <br/><br/>Setting: Setting was the ED of a 258 bed, academic pediatric hospital in the mid-Atlantic region of the United States. The ED was a level I trauma center with an annual volume of 76,000 patients.<br/><br/>Participants/Subjects: Participants were selected from the ED database. Eligibility criteria included all LWOT patients with a telephone number, English speaking and parental contact listed on the medical record. Fifty-one patients/parents met inclusion criteria. Subjects were parents of pediatric LWOT patients because they were the decision makers for the LWOT experience.<br/><br/>Methods: The researcher developed two instruments. Due to researcher's inability to obtain written consent from parents prior to chart audit and telephone interview, the ED performance improvement team completed data collection as a part of the department's quality program. The team summarized all data on an Excel spreadsheet, removing all patient and parent identifiers prior to providing data to researcher for analysis. Researcher applied descriptive and inferential statistical analysis to data using SPSS software. The one-tailed t-test with a p&lt;0.05 was used to determine whether a statistically significant difference existed between actual and perceived wait times for LWOT. A plan to reduce LWOT occurrences was then developed and submitted for departmental approval.<br/><br/>Results/Outcomes: The parents' perceived wait time (119.41 minutes) was significantly longer that actual wait time (87.27 minutes). Researcher identified five general categories of parental dissatisfaction: staff uncaring/indifferent; inadequate explanation of delays; inadequate comfort measures; inadequate food/drink/diapers; excessive wait time; and felt better so left. Ninety-two percent of parents identified 30 minutes as an acceptable wait time.<br/><br/>Implications: Study provided insight into parental decision-making when making the LWOT decision and identified opportunities to reduce the LWOT occurrence. The plan provided specific strategies to reduce the two primary and three secondary risks associated with the LWOT experience: improved patient outcomes, reduced risk for EMTALA violation, improved patient/family satisfaction, increased revenues, and improved market share.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:30:11Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:30:11Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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