Structure and operational organization of pediatric emergency services: a Spanish national survey

Background: A good understanding of the structure and operational organization of pediatric emergency departments (EDs) is essential for the design and promotion of interventions that can lead to improvement Objectives: 1) To describe the structure and operational organization of pediatric EDs in Spanish hospitals 2) To determine the degree of fulfillment of the basic quality indicators established by the Spanish Society of Pediatric Emergency Medicine (SEUP). Methods: The SEUP Quality Group designed a questionnaire to measure the described objectives Forty hopstial EDs with SEUP members were surveyed Answers received between September 2006 and January 2007 were analyzed Results: Thirty-four questionnaires were received Twenty-three EDs had a chief of staff, 25 had emergency staff, and 30 had residents in different years of training. On most nights and weekends, medical care is given by nonemergency staff Eighteen EDs had problems when staff doctors were on leave. The EDs surveyed were compliant on 56% to 88% of the items related to the dimension "diseases" Under the dimension "activities", 7 (21%) did not have a triage system On items related to documentation, all EDs (100%) completed care reports and 22 entered diagnostic codes Under the dimension "workplace resources", 33 (97%) performed a check of the crash cart Conclusions: Important opportunities for improvement were identified at the levels of structural organization and functioning The lack of an ED chief of staff and/or permanent staff was the main factor causing the detected problems The analysis of quality indicators shows that compliance is acceptable in the area of diseases but was deficient in those of activities and documentation, probably due to inadequate computer systems. [Emergencias 2008;20:322-327]