Improving pediatric hematology/oncology care in the emergency department

Purpose: Pediatric hematology/oncology patients frequently use the emergency department (ED) for prompt care during potentially life-threatening events, such as sepsis and bleeding. One challenge of these visits is the unavailability of appropriate patient-specific medical information. Lack of information may result in ineffective ED visits for these patients with complex conditions. Methods: A cross-sectional survey to determine ways to improve the care of pediatric hematology/oncology patients in the ED setting was conducted among parents at two affiliated pediatric hematology/oncology clinics. ED physicians in the catchment area of the clinic completed a separate survey. Results: All physicians surveyed were confident in caring for pediatric patients in the ED; however, fewer were confident in caring for pediatric hematology/oncology patients. Physicians and parents reported that the patient's written medical history (physicians, 30%; parents, 33%), medication list (physicians, 28%; parents, 24%), on-call pediatric hematologist/oncologist contact information (physicians, 34%; parents, 31%), and needle size and gauge to access the patient's port (physicians, 8%; parents, 12%) would be valuable information to have when presenting to the ED. Conclusion: Parents were satisfied with ED care, but both physician and parent respondents thought additional information would be valuable to have available at the visit to help facilitate effective care.