{"pk":12679,"title":"A Playroom Internal Waiting Area Improves Productivity in the Pediatric Emergency Department","subtitle":null,"abstract":"Introduction: \nPediatric emergency department (PED) volume is often constrained by the number of available treatment rooms. In many PEDs patients occupy treatment rooms while awaiting test results or imaging, thereby delaying care for patients who arrive after them.\nMethods: \nWe opened a PED where selected patients were moved to a playroom when they did not actively require a treatment room. The treatment room was then available for the next patient. We measured the effect of using the playroom on time from arrival to rooming and length of stay (LOS) using proportional hazards regression and the odds of being roomed within 30 minutes of arrival using logistic regression. We adjusted for the number  of the previous eight patients who were “playroom eligible”; age; triage category; provider; the number of patients who arrived within the preceding hour; prior census; and testing ordered in the preceding eight patients.\nResults:\n We analyzed 43,634 patient encounters, of which 10,134 (23%) were playroom eligible. The adjusted hazards ratio for the next patient being roomed was 1.14 (95% confidence interval [CI], 1.10-1.18) per prior playroom eligible patient. The adjusted odds ratio of the next patient being roomed within 30 minutes was 1.46 (95% CI, 1.33-1.56) per prior playroom eligible patient. The playroom typically decreased median rooming time by four to 42 minutes and LOS by two to 40 minutes depending on patient volumes and acuity. The benefit of the playroom was maximal at busier times.\nConclusion:\n Implementing a playroom in the PED for selected patients generally decreased time to rooming of the next patient and LOS.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Patient flow, Pediatric emergency department"},{"word":"Playroom"},{"word":"Length of Stay"},{"word":"Revenue"}],"section":"Emergency Department Operations","is_remote":true,"remote_url":"https://escholarship.org/uc/item/8vj884m3","frozenauthors":[{"first_name":"Paul","middle_name":"","last_name":"Walsh","name_suffix":"","institution":"Sutter Medical Center, Department of Pediatric Emergency Medicine, Sacramento, California","department":"None"},{"first_name":"Jennifer","middle_name":"","last_name":"Denno","name_suffix":"","institution":"Sutter Medical Center, Department of Pediatric Emergency Medicine, Sacramento, California","department":"None"}],"date_submitted":"2019-04-14T08:12:33Z","date_accepted":"2019-04-14T08:12:33Z","date_published":"2020-02-21T20:44:22Z","render_galley":null,"galleys":[{"label":"","type":"pdf","path":"https://journalpub.escholarship.org/westjem/article/12679/galley/6702/download/"}]}