System Stresses in 2 Pediatric Emergency Departments and 2 Pediatric Urgent Care Centers During the 2014 Enterovirus-D68 Outbreak.

Creator(s)

Gregory P. Conners, Children's Mercy HospitalFollow
Stacy J. Doyle, Children's Mercy HospitalFollow
Milton A. Fowler, Children's Mercy HospitalFollow
Lisa L. Schroeder, Children's Mercy HospitalFollow
Thomas W. Tryon, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

4-1-2018

Identifier

DOI: 10.1097/PEC.0000000000000856

Abstract

Objective: To describe the association of an unprecedented large-scale Enterovirus-D68 outbreak in 2014 with changes in patient volume and acuity and system stress in 2 pediatric emergency departments and 2 pediatric urgent care centers of a single children's hospital.

Methods: We compared measures of patient volume, acuity, and system stress during the 2014 Enterovirus-D68 outbreak and the corresponding dates of the previous year.

Results: Both settings experienced large census increases during the Enterovirus-D68 outbreak; patient census increased significantly more in the pediatric urgent care setting (20.3%) than in the pediatric emergency departments (14.3%). Both settings had significant increases in patient acuity. The proportion of pediatric emergency department patients requiring hospital admission increased; the proportion of patients who left the pediatric urgent care setting without being seen also increased. Although there was no emergency department inpatient boarding during the 2013 comparison period, 4.4% of admitted patients required emergency department boarding during the 2014 outbreak. There was no significant change in the mean length of stay or the probability that patient admission was to the pediatric intensive care unit.

Conclusions: Both the pediatric emergency departments and the pediatric urgent care centers experienced increased patient volumes and acuity and significant system stress in association with the 2014 Enterovirus-D68 outbreak. These data will inform those planning resource allocation for future large-scale viral outbreaks.

Journal Title

Pediatric emergency care

Volume

34

Issue

4

First Page

250

Last Page

252

MeSH Keywords

Emergency Service, Hospital/utilization; Ambulatory Care Facilities/utilization; Enterovirus D, Human; Disease Outbreaks; Hospitals, Pediatric

Keywords

Urgent Care; Emergency Departments; Enterovirus-D68; system demands; epidemics

Recommended Citation

Conners GP, Doyle SJ, Fowler MA Jr, Schroeder LL, Tryon TW. System Stresses in 2 Pediatric Emergency Departments and 2 Pediatric Urgent Care Centers During the 2014 Enterovirus-D68 Outbreak. Pediatr Emerg Care. 2018;34(4):250-252. doi:10.1097/PEC.0000000000000856