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The Art of Referral: Pediatricians and the Emergency Department

The Art of Referral: Pediatricians and the Emergency Department Abstract The increasing complexity of primary pediatric care is focusing renewed attention on the relationship between the pediatrician and emergency department (ED) physician. Primary-care pediatricians and emergency physicians (EP) are colleagues in the provision of coordinated care to pediatric patients. Whether referral is made to an ED specializing in pediatric emergency medicine or to an ED serving primarily adults, pediatricians and EPs must communicate effectively to provide the best possible patient care. In this article, we discuss the general process of referral, and present the example of Children's National Medical Center (CNMC), Washington, DC, as a successful system for processing referrals in the ED. We review the necessary information for the smooth transition of care from the physician's office to the ED. Potential problem areas and solutions are discussed. Checklists with potential value for both pediatricians and EPs are presented. WHY PEDIATRICIANS REFER TO EDs The reasons for referral generally fall References 1. Hilker TL. Nonemergency visits to a pediatric emergency department . J Am Coll Emerg Physicians . 1978;7:3-8.Crossref 2. Smith RD, McNamara JJ. Why not your pediatrician's office? a study of weekday pediatric emergency department use for minor illness care in a community hospital . Pediatr Emerg Care . 1988;4:107-111.Crossref 3. Kelman HR, Lane DS. Use of the hospital emergency room in relation to use of private physicians . Am J Public Health . 1976;66:891-894.Crossref 4. Halperin R, Meyers AR, Alpert JJ. Utilization of pediatric emergency services . Pediatr Clin North Am . 1979;26:747-757. 5. Kunian L. Role of the emergency department in a community hospital . N Engl J Med . 1976;283:1367-1370.Crossref 6. McCloskey KA, Johnston C. Critical care interhospital transports: predictability of the need for a pediatrician . Pediatr Emerg Care . 1990;6: 89-92.Crossref 7. American Academy of Pediatrics, Committee on Pediatric Emergency Medicine . Emergency Medical Services for Children: The Role of the Primary Care Provider . Elk Grove Village, Ill: American Academy of Pediatrics; 1992. 8. Murray M, Templeton A. Legal Considerations in pediatric trauma . In: Eichelberger MR, ed. Pediatric Trauma . Philadelphia, Pa: BC Decker Inc; 1992. 9. American Academy of Pediatrics, Committee on Hospital Care. Guidelines for air and ground transportation of pediatric patients . Pediatrics . 1986; 78:943-950. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

The Art of Referral: Pediatricians and the Emergency Department

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Publisher
American Medical Association
Copyright
Copyright © 1993 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1993.02160330068022
Publisher site
See Article on Publisher Site

Abstract

Abstract The increasing complexity of primary pediatric care is focusing renewed attention on the relationship between the pediatrician and emergency department (ED) physician. Primary-care pediatricians and emergency physicians (EP) are colleagues in the provision of coordinated care to pediatric patients. Whether referral is made to an ED specializing in pediatric emergency medicine or to an ED serving primarily adults, pediatricians and EPs must communicate effectively to provide the best possible patient care. In this article, we discuss the general process of referral, and present the example of Children's National Medical Center (CNMC), Washington, DC, as a successful system for processing referrals in the ED. We review the necessary information for the smooth transition of care from the physician's office to the ED. Potential problem areas and solutions are discussed. Checklists with potential value for both pediatricians and EPs are presented. WHY PEDIATRICIANS REFER TO EDs The reasons for referral generally fall References 1. Hilker TL. Nonemergency visits to a pediatric emergency department . J Am Coll Emerg Physicians . 1978;7:3-8.Crossref 2. Smith RD, McNamara JJ. Why not your pediatrician's office? a study of weekday pediatric emergency department use for minor illness care in a community hospital . Pediatr Emerg Care . 1988;4:107-111.Crossref 3. Kelman HR, Lane DS. Use of the hospital emergency room in relation to use of private physicians . Am J Public Health . 1976;66:891-894.Crossref 4. Halperin R, Meyers AR, Alpert JJ. Utilization of pediatric emergency services . Pediatr Clin North Am . 1979;26:747-757. 5. Kunian L. Role of the emergency department in a community hospital . N Engl J Med . 1976;283:1367-1370.Crossref 6. McCloskey KA, Johnston C. Critical care interhospital transports: predictability of the need for a pediatrician . Pediatr Emerg Care . 1990;6: 89-92.Crossref 7. American Academy of Pediatrics, Committee on Pediatric Emergency Medicine . Emergency Medical Services for Children: The Role of the Primary Care Provider . Elk Grove Village, Ill: American Academy of Pediatrics; 1992. 8. Murray M, Templeton A. Legal Considerations in pediatric trauma . In: Eichelberger MR, ed. Pediatric Trauma . Philadelphia, Pa: BC Decker Inc; 1992. 9. American Academy of Pediatrics, Committee on Hospital Care. Guidelines for air and ground transportation of pediatric patients . Pediatrics . 1986; 78:943-950.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Sep 1, 1993

References