title: Alternatives to ward admission from the emergency department.
abstract: There is ever-increasing pressure on hospital resources in general and emergency departments (ED) in particular. At the same time, there is increasing recognition that traditional inpatient ward-based care is not necessary for the majority of children presenting to the ED with acute illness, and that there are patient, family and hospital benefits to pursuing other options. Here, we describe alternative pathways for children presenting to the ED, including short stay and observational medicine, hospital-in-the-home and non-admission enhanced care, in other words, additional management practices or pathways for children who are discharged from the ED. We discuss the principles, models and practical considerations involved in each of these.
authors.affiliation: Departments of General Medicine and, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.|RCH@Home, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.|Emergency Department, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.|Murdoch Children's Research Institute.|Department of Paediatrics, University of Melbourne, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.
authors.forename: Penelope A
authors.initials: PA
authors.lastname: Bryant
authors.affiliation: Emergency Department, The Royal Children's Hospital Melbourne, Melbourne, Victoria, Australia.|Murdoch Children's Research Institute.
authors.forename: Sandy M
authors.initials: SM
authors.lastname: Hopper
mesh_terms: D000208:Acute Disease; D002648:Child; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration; D006801:Humans; D007902:Length of Stay; D010343:Patient Admission; D000070316:Pediatric Emergency Medicine / Q000379:methods* / Q000458:organization & administration; D057832:Watchful Waiting / Q000379:methods
keywords: home care services; hospital-based; hospital-in-the-home; observation ward; short stay unit