Paediatric Admission Process:
Creating the Balance Between Tertiary Care and Community Hospital Facilities
Most admissions originate from Emergency Departments (primarily at the tertiary hospital). Currently in Calgary there is one Tertiary care hospital (112 inpatient beds) and one community hospital paediatric unit (12 beds). No agreement to determine inpatient placements in the present structure. A possible increase in current community hospital paediatric unit to 24 beds has been suggested as has a future community hospital paediatric unit planned with a potential additional 24 beds.
The question that this local project sought to answer was: what are the current admission practices for paediatric patients in settings where both tertiary care and community hospitals exist? To facilitate answering the larger question, two sub-questions arose. The first sub-question was used to direct the search of the available literature. The question was: in the literature, is there any information describing and supporting current admission practices for paediatric patients in centers where both tertiary care hospitals and community paediatric inpatient units exist? The second sub-question arose from the paucity of literature and was answered through a series of expert consultations. This question was: what are the current Canadian practices regarding the placement of admitted pediatric patients in either tertiary care paediatric facilities or community hospital paediatric units and is there literature to support these practices?
The SEARCH VI local project sought to answer these questions through both a structured review of the available literature, and a number of consultations with key Canadian experts.
The systematic literature review included the following databases: EBSCO (CINAHL with and without full text, MEDLINE with and without full text, Health Business Fulltext Elite), Pubmed, Google Scholar, ABI inform, National Guideline Clearinghouse, Medal.org (Medical Algorithms), and several Grey literature sites. The Alberta Children’s Hospital library staff was invaluable resources to help ensure saturation was reached in the search through the databases
In the literature review, the SEARCH participant used the following key phrases (in isolation and in various combinations) until saturation was achieved. The search was limited to the paediatric population and then the neonatal population was added. A focus on in-patient admission (or just admission)