Quality Improvement of Services for Inpatients After Implementation of a Pediatric Nurse Coordinator and Porter

Abstract

Background: Delays in finding inpatient beds and transferring patients lead to overcrowding in the Emergency Department (ED).

Local problem: The emergency nurse coordinator role was implemented in the general or adult ED to optimize patient flow, but few studies are available for pediatric hospitals.

Objective: The aim was to assess the impact of a pediatric emergency nurse coordinator and an ED porter on the ED length of stay for inpatients.

Methods: A retrospective before-after study was conducted in a pediatric hospital. ED inpatient length of stay was compared between December 2015 and December 2016. The probability to get an ED length of stay below the median was modeled in multivariate analysis.

Intervention: A pediatric emergency nurse coordinator and ED porter were implemented in 2016.

Results: 1086 hospitalized children were included. The ED length of stay was significantly longer in 2016 (median: 5.5 h, IQR: 3 h and 49 min, 7 h and 22 min) than in 2015 (median: 4.8 h, IQR: 3 h and 19 min, 6 h and 18 min). The year 2015 (OR 1.56, 95% CI [1.1, 2.2]), the absence of imaging, the absence of aerosol and IV drug administration, the number of hospitalizations on the day below the median, type of hospitalization unit, and the age of children younger than 1 years old were associated with a shorter ED length of stay (below the median) in the multivariate analysis.

Conclusion: Our study did not confirm the advantages of these two professionals in our pediatric ED.

Keywords: emergency department; health care quality; pediatrics.