This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is this research about?
Children usually go through the emergency department, or ED, to be admitted to the hospital. But going through the ED may not be the most efficient way for patients and their families to get care. Wait times in the ED can be long. Also, clinicians in the ED don’t know a child’s health history as well as the child’s primary care doctor.
Another way to admit children to the hospital is direct admission. With direct admission, the child’s primary care or urgent care doctor contacts the hospital to admit the child. Direct admission can improve communication between the child’s doctor and hospital staff. But hospitals need to set up a process for direct admission.
In this study, the research team is comparing how quickly children receive care with direct admission versus admission through EDs. The team also wants to see if direct admission helps some patients more than others or improves families’ experience of care.
Who can this research help?
Results may help hospital administrators when considering ways to improve hospital admissions.
What is the research team doing?
The research team is assigning 3 hospitals and 47 children’s health clinics by chance to start the direct admission process at different times during the study. The team is looking at hospital records for children admitted for infections or other common health problems to see
- How quickly children get care after arriving at the hospital
- How often children are admitted to intensive care
- How often children stay at the hospital for less than one day
- Families’ experiences with hospital admission
Also, during their child’s hospital stay, parents answer surveys about their experience with hospital admission.
The research team is comparing patients within the same doctors’ offices before and after the offices start the direct admission process.
Families of children admitted to hospitals, doctors, nurses, and hospital staff help with this study.
Research methods at a glance
Cluster randomized controlled trial
|1,696 children up to age 17 from 3 hospitals and 47 children’s health clinics across the United States
Primary: length of time from arrival at the hospital until the start of definitive clinical care
Secondary: rate of transfer to pediatric intensive care, hospital stays <12 or <24 hours, family hospital admission experience
|6-hour follow-up for primary outcome
Related Journal Citations
^This project was originally affiliated with the Trustees of Dartmouth College.