Abstract
Objective
To determine whether using emergency department (ED) virtual observation for select
pediatric conditions decreases admission rates for these conditions, and to examine
effects on length of stay.
Methods
The option of ED virtual observation care for 9 common pediatric conditions was introduced
in 2009; associated order sets were developed. Retrospective secondary analyses of
administrative data from our tertiary care pediatric ED and children's hospital were
performed for the year before (year 0) and after (year 1) this disposition option
was introduced. The proportion of visits admitted to the inpatient unit and length
of stay (LOS) were determined for all visits considered eligible for ED virtual observation
care on the basis of diagnosis codes for both study years.
Results
There were 1614 observation-eligible visits in year 0 and 1510 in year 1. In year
1, 18% (n = 266) of observation-eligible visits received ED virtual observation care.
Admission rates for observation-eligible visits were similar after this model of care
was introduced (25% year 0, 29% year 1, P = .02). Median LOS for ED virtual observation visits was 8.8 hours (interquartile
range 6.5–12.4). ED LOS was shorter for ED discharges (5.6 hours year 0, 5.1 hours
year 1, P < .001) and unchanged for admissions (6.0 hours year 0, 5.8 hours, year 1, P = .41) after introducing ED virtual observation.
Conclusions
Admission rates for observation-eligible visits were not lower in the year after ED
virtual observation care was introduced. LOS decreased for ED discharges and was unchanged
for admissions. Reevaluation of the effects of pediatric ED virtual observation on
admission rates and LOS after longer periods of use is indicated.
Keywords
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Article Info
Publication History
Accepted:
March 12,
2014
Received:
November 14,
2013
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
