TABLE 3

Clinical Indicators of ED Care for Children Chosen by the Expert Panel

Adolescent mental health problems, 12–19 yPercentage of patients assessed by a crisis team in the ED
Percentage of patients not seen by a crisis team in the ED with an outpatient follow-up arranged within 7 d
Ankle injury, 5–19 yPercentage of patients who present to the ED with an ankle/foot injury who receive an radiographa
Percentage of ankle radiographs that are negative
Time from triage to ankle radiograph
Asthma, 1–19 yPercentage of patients treated with antibiotics in the ED
Percentage of patients treated with oral steroids and discharged home
Percentage of patients admitted to hospital with steroid administration in the ED (IV or oral)
Percentage of patients discharged home from the ED with a prescription/supply for oral steroids
Percentage of patients discharged home from the ED with a short-term medication management written care plan
Percentage of patients discharged with follow-up instructions
Unplanned return visit to any ED within 24 h of index visit for same/related asthma exacerbationa
Unplanned return visit to any ED between 24 and 72 h of index visit for same/related asthma exacerbationa
Percentage of patients who receive a chest radiograph during the ED visita
Bronchiolitis, 3 mo to 2 yPercentage of patients who receive a chest radiograph during the ED visita
Percentage of patients treated with antibiotics in the ED
Croup, 3 mo to 3 yPercentage of patients who receive a chest or lateral neck radiograph during the ED visita
Unplanned return visit to any ED within 24 h of index visit for same/related conditiona
Percentage of patients treated with steroids in the ED
Percentage of patients admitted to hospital who did not receive steroids in ED
Gastroenteritis, 0–19 yUnplanned return visits to any ED within 24 h of index visit for same/related conditiona
Percentage of patients treated with IV therapy who initially received isotonic solutions
Percentage of patients discharged from the ED with a written care plan
Fever
    0–28 dPercentage of patients receiving broad spectrum IV antibiotics
Percentage of patients admitted to hospitalb
Percentage of patients receiving a full septic workup
Time from triage to initiation of septic workup
Time from triage to administration of antibiotics
    28–90 dUnplanned return visits to any ED within 48 h of index visit for same/related conditionb
Percentage of patients whose blood and urine is cultured
Percentage of patients who have a complete blood count drawn
Percentage of patients discharged from the ED with a written care plan
Percentage of patients discharged from the ED with follow up arranged within 48 h
Unplanned return visits to any ED within 72 h of index visit for same/related conditiona
Percentage of patients whose blood and urine is cultured
Percentage of patients who have a complete blood count drawn
    3–24 moPercentage of patients discharged from the ED with a written care plan
Percentage of patients discharged from the ED with community follow-up arranged
Unplanned return visits to any ED within 72 h of index visit for same/related conditiona
Percentage of patients whose blood and urine is cultured
Percentage of patients who have a complete blood count drawn
Percentage of patients who receive a chest radiograph during the ED visita
Percentage of patients admitted to hospital and have an inpatient length of stay of <24 hb
    2–19 yUnplanned return visits to any ED within 72 h of index visit for same/related conditiona
Jaundice, 0–1 moPercentage of patients who have a bilirubin drawn
Time from triage to initiation of phototherapy
Minor head injuryPercentage of patients who receive a head CT scan
    0–2 yPercentage of head CT scans that are negative
Percentage of patients who receive a skull radiograph
Percentage of skull radiographs that are negative
    2–19 yPercentage of patients who receive a head CT scan
Percentage of head CT scans that are negative
Percentage of patients who receive a skull radiograph
Percentage of skull radiographs that are negative
Seizures, 0–19 yPercentage of patients requiring ventilatory supporta
Type 1 diabetes, 0–19 yPercentage of patients with ketoacidosis treated initially with IV normal saline
Time from triage to initiation of IV therapy for patients with ketoacidosis
Unplanned return visits to any ED within 72 h of index visit for same/related conditiona
Urinary tract infection
    0–3 moPercentage of patients whose urine is cultured
Percentage of urine cultures obtained by catheter or suprapubic aspiration
Percentage of patients whose blood is cultured
Percentage of patients admitted to hospitalb
    3 mo to 3 yUnplanned return visits to any ED within 72 h of index visit for same/related conditionb
Unplanned visits to primary care within 72 h of index visit for same/related condition
Percentage of patients whose urine is cultured
Percentage of urine cultures obtained by catheter, suprapubic, or midstream methods
Percentage of patients admitted to hospital with no underlying renal disease
    3–19 yPercentage of patients whose urine is cultured
Unplanned return visits to any ED within 72 h of index visit for same/related conditiona
  • Ratings are based on the panel's final responses to questionnaire 2, after the 1-day meeting. IV indicates intravenous; CT, computed tomography.

  • a Indicators that could be measured at this time using the NACRS database.

  • b Indicators that could be measured at this time using NACRS, but >25% of all hospitals have <5 cases.