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Understanding Nonurgent Pediatric Emergency Department Visits: Using Hospital and Family-Centric Data to Inform System Redesign

Swavely, Deborah DNP, RN; Baker, Kathy MPH, RN; Bilger, Krista BSN, RN; Zimmerman, David F. MPH; Martin, Andrew MSN, RN

doi: 10.1097/NCQ.0000000000000126

We conducted a mixed-method study to analyze the population and financial impact of emergency department use for pediatric nonurgent problems. Findings from this initial study led to our phase 2 case study, in which we interviewed 23 adults accompanying children younger than 4 years with nonemergent fever. The resulting qualitative analysis revealed that participants were unable to distinguish urgent from nonurgent conditions, perceived access limitations to care, and although they preferred the child's primary care physician, went to the emergency department for care.

Health Systems Research and Innovation (Dr Swavely, Ms Baker, and Mr Zimmerman) and Department of Emergency Medicine (Ms Bilger and Mr Martin), Lehigh Valley Health Network, Allentown, Pennsylvania.

Correspondence: Deborah Swavely, DNP, RN, Health Systems Research and Innovation, Lehigh Valley Health Network, 1628 W Chew St, SON, Allentown, PA 18102 (

The authors declare no conflicts of interest relative to this work.

Accepted for publication: March 29, 2015

Published ahead of print: May 26, 2015

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