Impact of an annexed influenza clinic on the efficiency of a pediatric emergency department
Hallock, Grant Connell
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Influenza is a highly contagious respiratory virus that can cause very severe health complications in people, and can be especially dangerous for young children. The peak influenza season occurs in the winter months with February usually being the month with the highest number of reported infections. As the virus can cause serious illness, pediatric institutions during the winter months see a very large number of patients who have influenza or influenza related complications. Pediatric Emergency Departments (ED) similarly see a dramatic increase in the number of patients who visit the ED during the winter influenza season. Therefore, it is important that pediatric EDs develop ways to handle the increased patient population while still maintaining quality care to the rest of the ED. Thus, a novel influenza clinic run entirely by non-ED Nurse Practitioners (NP) was implemented into the operations of the ED as an annexed clinic in February 2013 during the winter influenza season. The clinic was beneficial in improving the average quality measures of the ED against similar days without the influenza clinic, lowering the average length of stay (LOS) by 24 minutes (13% decrease) and lowering the left without being seen rates (LWBS) by 1.35% (3 fewer patients on average). In addition, using NPs instead of higher cost physicians dramatically lowered the cost of the clinic by nearly half. While the influenza clinic was beneficial in lowering the average LOS and LWBS rates against similar days without the clinic the data did not reach statistical significance, perhaps due to the small amount of data available. The results, despite the statistical insignificance, show a promising future in addition of an NP run influenza clinic to handle the increased patient population during the winter influenza season.