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Paediatric Admissions

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identified as were exclusion criteria to exclude the transfer of children at risk for deterioration or who required the need for a subspecialist.  Descriptive, exploratory and qualitative data were collected during the one year research period and a number of statistical analyses were conducted to examine which children remained in the tertiary care center and which children were transferred to community or regional care facilities.  The results of the study confirmed the safety in the newly implemented transfer procedures although the authors commented that many parents might not agree to a similar transfer in the future. They also commented that only a small reduction in Emergency Department visits occurred as a result of the new process. The key features identified to facilitate the process included: effective communication between the tertiary care and community hospital, an increase in paediatric beds in the outlying hospitals, use of non-medical means for transferring patients (ie taxi or private vehicle) when appropriate, and buy in from the communities. The study concluded that the results could be generalized to other publically funded centers and supported regionalization of care.  The editorial, included later in the journal, supported the transfer of those patients assessed to have low acuity and for whom care could be provided in their own community hospitals. The discussions in these two articles were directly applicable to the SEARCH project and the article and editorial were provided to SEARCH participant’s director for further analysis.

Conclusion of the Literature Review

The first sub-question was largely unanswerable due to paucity of relevant articles. In summary, 24 publications were analyzed and there was very little relevant data was published. Many of the articles examined various different models in differing populations too divergent to be considered for in-depth analysis. In the six articles that met the inclusion criteria for the study, common themes extracted and the potential for application across populations was summarized. The results of the literature search were discussed with the SEARCH participant’s director and the decision to conduct the expert consultation was made.

Expert Consultations

After completing a search of the literature, a decision was made to conduct telephone interviews with key informants in Canadian paediatric tertiary care centers. All of the centers belong to the Canadian Association of Paediatric Health Centers (CAPHC). The coordinator for the Canadian Paediatric Decision Support Network, a program of the CAPHC organization was contacted and asked to distribute a

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