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Pediatr Emerg Care. 2020 Feb 1. doi: 10.1097/PEC.0000000000002031. [Epub ahead of print]

The Parent Perspective on Return Visits to the Pediatric Emergency Department: A Missing Piece of the Puzzle.

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From the Division of Emergency Medicine, Department of Pediatrics, Hospital for Sick Children.
Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.



Return visits to the pediatric emergency department (ED) give insight into the unmet needs of patients and families. The aim of this study was to capture the parent perspective on factors contributing to return visits to the pediatric ED.


This is a prospective cohort study consisting of an 11-item survey that was administered to parents of children who had a return visit to the ED less than 72 hours from their initial visit. Surveys were distributed over an 8-month period between November 2015 and June 2016.


The primary reason parents report for returning to the ED is that their child had ongoing or worsening symptoms (55%). Parents were satisfied with the care they received at the initial ED visit (89% report excellent, very good or good care). For parents who report that the initial visit could have been improved, they report wanting more tests done (54%), a better follow-up plan arranged by the ED (31%), consultation with a specialist (26%), admission to hospital on the initial visit (26%), and better communication and more time spent with the ED physician (21%). The majority (97%) of parents reported that their child has a primary care provider, and 39% of parents brought their child to a health care provider for the same problem in the 7 days before their return visit to the ED.


The parent perspective gives important insights into the reasons for return visits to the pediatric ED. Conclusions from this study will help inform future quality improvement initiatives that direct health care resources to provide high value care to patients and families.

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