Pediatric resident, R4 University of Alberta Faculty of Medicine and Dentistry Edmonton, Alberta, Canada
Background: Pediatric emergency departments (ED) are fast-paced environments with many inherent challenges to establishing trust and connection between families (patient and caregivers) and health care providers. Better patient and family care experiences is associated with improved health outcomes. Understanding caregiver needs can improve families’ emergency department (ED) experience and care. Objective: This study describes caregivers’ perceived overall pediatric ED experience and operational needs and to what extent these were met. Design/Methods: This descriptive, cross-sectional survey with medical record review was conducted at 10 Canadian pediatric EDs from October 2018 to March 2020, over a 1-week period every season, for a total of 4 weeks per site. Caregivers filled bilingual electronic surveys during the ED visit or within 7 days post-visit. Results: Of the 2005 caregivers who participated, the majority (74.3%, 1462/1969) were mothers with a mean age of 37.8 years (SD 7.7). The mean child age was 5.9 (SD 5.1) years and 51.9 % (1040/2003) were male. Median (IQR) length of stay was 3.9 (2.6, 6.1) hours. Overall, 22.1% (322/1454) of caregivers reported that their overall needs were not adequately met (Likert scale 1-3 out of a possible 5). The top three unmet needs during the ED visit were prompt medical care [20.3%, (194/955)], access to practical items [16.8%, (160/955)] and effective/clear communication [8.7% (83/955)]. The most desired ED improvements were better communication of wait times/delays [(41.1%, 745/1812)], shorter wait times [(38.8%, 699/1801)] and quicker diagnosis [(24.9%, 449/1803)]. Caregiver needs being met was associated with their child’s needs being met (OR 21.2 [13.1, 34.2]), child’s pain being well managed (OR 3.7 [2.4, 5.6]), and satisfaction with the ED visit duration (OR 2.6 [1.8, 3.8]). Caregivers were more likely to be satisfied with overall length of ED visit when their child’s (OR 3.2 [2.0, 5.2]) or their own (OR 2.9 [1.9, 4.3)] needs were met.
Conclusion(s): Approximately one quarter of Canadian caregivers report that their overall needs were not fully met when attending the pediatric ED. Enhancing the quality of ED experience through better communication of wait time delays, timely medical updates, and prompt initiation of pain care at triage may immediately implement local strategies to ameliorate family ED experiences while policymakers work nationally to address lengthy wait times.
