title: Reduction of pediatric emergency hospital admissions by a change in pediatric emergency department policy.
abstract: BACKGROUND
  Reduction in admissions is an important aim of emergency department working policy to overcome the problems of a shortage of inpatient beds, rising costs and exhausted resources. A new policy was instituted in the pediatric emergency department (PED) of a hospital in Kuwait with the following components: (1) assigning senior doctor staff (2) implementation of new disease management guidelines; and (3) maximizing the use of the pediatric emergency department observation unit.
  
  
  OBJECTIVE
  to evaluate the effect of change in our policy on the admission rate.
  
  
  METHODS
  The effects of this policy on reduction of admission rates for total pediatric admissions and for some selected common pediatric conditions were prospectively studied over a period of 3 years from institution of the policy and compared with the 3-year period before the policy was instituted.
  
  
  RESULTS
  There was a significant reduction in admission rates after institution of the new policy. The proportion of hospital admissions to PED observation unit cases was significantly reduced as a whole from 64.9% ± 5.1% to 33.2 ± 0.6% and also for the common pediatric problems studied.
  
  
  CONCLUSIONS
  A multidisciplinary pediatric emergency department policy, using as much available evidence as possible, was successful in significantly reducing pediatric hospital admissions.
authors: Consultant of Pediatric Emergency, Aladan Hospital, Kuwait.
authors: Marzouq A
authors: MA
authors: Alazmi
authors: Ahmed F
authors: AF
authors: Elhassanien
keywords: Change in emergency policy; pediatric admission; pediatric emergency
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