Current situation of pediatric emergency departments in Argentine public hospitals.

Abstract

Introduction. The quality improvement cycle in health care requires surveys and measurements. This study, based on data from a Latin American collaborative research project, aimed to describe the situation of pediatric emergency departments (PEDs) in Argentina and identify opportunities for improvement. Methods. Retrospective descriptive study. Data from 2019 were collected in PEDs of public hospitals with pediatric intensive care units (PICU). Continuous variables are presented as median and range, categorical variables as percentages, and productivity/resource ratios as ratios. Bivariate analysis was performed. Results. Out of 66 services, 62 (94%) participated. There was a deficit of isolation and specific pediatric care sectors; 21 (33.9%) PEDs had >70% of the equipment evaluated for the treatment of critical patients. Triage was performed in 34 (54.8%) PEDs. The median number of annual visits/observation beds was 7333 (IQR: 4,998-13,377); the median number of daily visits/consulting rooms was 37.6 (IQR 20.6-60.3). The number of beds increased by 75% at the seasonal peak. The median daily visits were 43/physician and 40.2/nurse. In 32 (51.6%) PEDs, there was 1 physician and 1 referring nurse per shift. Data were electronically recorded in 51 (82.2%) PEDs. Five critical care protocols were used in 44 (71%) PEDs, and 18 (29%) had a quality improvement plan. Five (8%) PEDs followed defined schedules for academic activities. Conclusion. This survey allowed us to know the situation of SEPs in Argentina's public hospitals and to identify opportunities for improvement.