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Pediatr Emerg Care. 2011 Jun;27(6):519-26. doi: 10.1097/PEC.0b013e31822255dd.

Pediatric alternate site of care during the 2009 H1N1 pandemic.

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  • 1Division of Emergency Medicine, Children's Hospital Boston, Boston, MA 02115, USA.



This study aimed to describe the design and implementation of an alternate site of care (ASC) for nonurgent pediatric patients with influenza-like illnesses during the 2009 H1N1 pandemic and to evaluate its performance.


We describe the design and physical implementation of an ASC. Evaluation of the utilization, patient demographics, throughput, safety, family satisfaction, and cost are presented.


The process of project development, site selection, clinical algorithms, staffing supplies, and cost are detailed. The ASC was used for 7.5 days, and 137 patients were treated. The median age was 6.5 years. Forty-five percent were male, and English was the primary language. Median length of stay for patients evaluated was 65 minutes. Of patients, 5.8% were transferred from the ASC to the ED for further care. Also, 2.3% of patients returned to the ED within 72 hours; however, none required admission. There were no adverse events associated with the ASC and 92% of families rated overall care as very good or excellent.


Selected nonurgent patients with influenza-like illness during a pandemic can be treated in a safe and timely manner with high levels of family satisfaction in a novel setting.

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