14502 Clark Eilidh

Tagged in Pediatrics

What do parents and children want from the new paediatric emergency department?

Background: In autumn 2018, the Royal Hospital for Sick Children, Edinburgh (RHSC) will relocate to Little France where the Royal Infirmary of Edinburgh (RIE) is currently based. The age limit will also increase from 13 to 16 years old, thus adolescents have been a key target population for qualitative research concerning the move. However, little work has been done to establish the views of other users of the RHSC. The aim of this project was to look at what parents, children <13 and staff think of the move, and explore what they would like from the new Emergency Department (ED) specifically.

Methods: Questionnaires were offered to all parents of children presenting to the current RHSC ED between 04/09/17 and 23/10/17 (n=250). Questionnaires were also given to ED staff during this period (n=36). Across November 2017, semi-structured qualitative interviews were conducted with a sample of 50 parents in the ED waiting room to explore emerging themes in more depth. Only parents who had not previously completed a questionnaire were selected for interview; there were no other exclusion criteria. Sampling was opportunistic to some extent, whereby parents with significantly unwell or distressed children were not approached. However, every effort was sought to achieve diversity in gender, ethnicity and age of both parent and child. Where appropriate, the presenting child was also asked for their views if aged <13.

Descriptive statistics were calculated using Microsoft Excel. 95% confidence intervals were obtained for relevant data sets using Minitab 17 Statistical Software. Associations between categorical variables were tested using Fisher’s exact test via IBM SPSS Statistics 22, and a significant level of 0.05 was adopted throughout.

Results/discussion: The move was regarded positively overall by parents (n=172/248, 69%) and staff (n=33/36, 92%), with a strong association between negative views and living further from the new site (p<0.001, n=196). Parents were also overwhelmingly positive about the new age limit (n=189/205, 92% (95% CI (0.876,0.955))), whereas staff felt more adolescent-specific training is needed in areas such as mental health, toxicology and sexual health. 

Children felt that waiting room entertainment, specifically Wi-Fi, was most important to the new ED. However, both parents and staff were more concerned with parking facilities and space in the waiting area – features which have hopefully been improved in the construction of the new hospital. Many parents were also worried about the impact of the adolescent population on ED waiting times. However, most parents (n=184/225, 82% (95% CI (0.761,0.866))) said they would be happy to take their child to a co-located GP, if appropriate, in order to improve patient flow through the department.