Standardizing pediatric care
(Edmonton) A child receiving treatment for croup—a respiratory condition—in an emergency department at a rural community hospital is almost 50 per cent less likely to receive the same level of care compared with treatment for the same condition in an urban city like Edmonton.
That’s according to a team of researchers, two of whom are from the University of Alberta, who have received a $2-million grant from the National Centre of Excellence to develop resources that will help ensure standardized pediatric care at emergency rooms across the country. Other researchers include David Johnson, University of Calgary, Mona Jabbour, University of Ottawa and Terry Klassen, University of Manitoba. Shannon Scott, U of A nursing assistant professor and project co-director, says theirs is the first such project that aims to close the knowledge gap on how health-care professionals in rural hospitals diagnose, care for and treat children.
“Evidence shows that as many as 40 per cent of children cared for in emergency room departments do not receive treatment from the latest and best research available to treat and manage an illness such as a respiratory disease like croup. And up to 20 per cent of children in these community hospitals may receive treatment that provided no benefit to them,” she said.
Researchers with the project, Translating Emergency Knowledge for Kids, or TREKK, will work with 36 hospitals from coast to coast to determine the information needs of health-care professionals on the diagnoses, treatment and care of medical conditions. Scott says the professionals are trained as generalists who are providing specialized care.
“What we’re trying to understand is what health-care professionals who work in these environments need to know to do their jobs. Because they are generalists, they have to be able to deal with whatever condition a child walks in with, and when they don’t have a lot of exposure to large numbers of children because that’s not their speciality, it can become challenging,” she said. A very large amount of health care for children is not provided in specialized pediatric hospitals by virtue of where the Canadian population lives.”
Scott says they will also work to determine the needs of patients seeking help from the community hospitals. “We’re also trying to understand how parents who bring children into the emergency room departments want to know about their children’s conditions. We’re hoping to develop innovative resources that we could use to help transfer complex medical information to parents,” she said.
So Scott and her team will be using iPads to collect statistical data on the information needs at the hospitals and then pass them to U of A researcher Lisa Hartling, who, along with her team, will conduct worldwide research to gather the best available evidence-based research to treat conditional needs identified by each hospital.
Hartling says there may be conflicting conclusions from existing studies on the effective treatment and care of a particular condition, but that her team will ensure they draw definite conclusions after reviewing all the studies, and produce suggestions for the best treatment approach on conditions identified by each hospital.
Hartling said another team of researchers would translate the research into clinical pathways—or clinical treatment guidelines—which will be provided to emergency room clinicians at the community hospitals. And each of the 36 hospitals will have that information resource tailored to meet their specific needs.
“My hope would be that by standardizing care and knowing what the evidence says, children across the country are going to be receiving care that’s based on the most recent and strongest evidence,” Hartling said.