Children are a particular challenge for emergency care providers. Emergency departments must provide pediatric-specific services to adequately meet children’s unique care needs and ensure positive outcomes. In 2019, Mount Sinai Beth Israel transformed its health system with the development of a combined pediatric ED and short stay observation unit to enhance child-centered care.
The hospital’s pediatric ED and short stay unit serves multiple aims: to provide child-centered care to families in its traditionally underserved community while providing support services to other hospitals without pediatric acute and inpatient services. The PED-SSU is the New York City region’s only observation unit designed for the ongoing management of children for a period of up to 48 hours. The combined unit manages the challenges of limited bed capacity in EDs and inpatient units and maximizes efficiency, quality and safety.
Using a hub-and-spoke model, the hospital also leveraged telemedicine resources to provide consultations to other hospitals and extend pediatric subspecialty care across the health system. By tracking patient outcomes, the data-driven, evidence-based process ensures care provided is safe, family-centered and consistent with current literature.
Of children requiring admission, 69.7% were treated in the SSU; only 15.3% required conversion to other care settings. Implemented Plan-Do-Study-Act cycles increased observation-eligible admissions and decreased both overall ICU admissions and ICU admissions for children with severe asthma. Patient experience scores on Press Ganey increased from the 36th to 92nd percentile over one year.
For more information, contact C. Anthoney Lim, MD, FAAP, medical director, pediatric emergency medicine and short stay unit, at firstname.lastname@example.org or 212.420.2890.