• Maya Haasz, Daniel Ostro, and Dennis Scolnik.
• Department of Pediatrics, Mackenzie Richmond Hill Hospital, Richmond Hill.
• Pediatr Emerg Care. 2018 Sep 1; 34 (9): 647-649.

ObjectivesHigh patient volumes have a deleterious effect on care in the pediatric emergency department (PED). Our study assessed the motivation for PED visits that could have been assessed by a primary care physician.MethodsWe identified a convenience sample of patients presenting to the SickKids Hospital PED in June and July 2011 with a Paediatric Canadian Triage and Acuity Score 4 or 5. Patients completed a forced answer yes/no survey describing potential motivators for visiting the PED. Visit appropriateness was determined by a modified version of the DeAngelis tool, an explicit criteria-based tool frequently used for this purpose.ResultsOf the included 635 patients with Paediatric Canadian Triage and Acuity Score 4 and 5, 25% were truly inappropriate as per DeAngelis criteria. Of these, perceived expertise at the tertiary care hospital (93.1%) and ease of getting tests (80.8%) were the most common reasons behind PED presentation.ConclusionsPatients presenting to our PED typically have primary care physicians; however, access to their physicians during off-hours and availability of off-site testing is limited. Public policy aimed at decreasing overcrowding in the PED should address these themes.

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