Clinical Indicators of ED Care for Children Chosen by the Expert Panel
| Adolescent mental health problems, 12–19 y | Percentage 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 y | Percentage 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 y | Percentage 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 y | Percentage 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 y | Percentage 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 y | Unplanned 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 d | Percentage 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 d | Unplanned 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 mo | Percentage 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 y | Unplanned return visits to any ED within 72 h of index visit for same/related conditiona |
| Jaundice, 0–1 mo | Percentage of patients who have a bilirubin drawn |
| Time from triage to initiation of phototherapy | |
| Minor head injury | Percentage of patients who receive a head CT scan |
| 0–2 y | Percentage of head CT scans that are negative |
| Percentage of patients who receive a skull radiograph | |
| Percentage of skull radiographs that are negative | |
| 2–19 y | Percentage 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 y | Percentage of patients requiring ventilatory supporta |
| Type 1 diabetes, 0–19 y | Percentage 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 mo | Percentage 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 y | Unplanned 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 y | Percentage 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.