Physician satisfaction with a pediatric observation unit administered by pediatric emergency medicine physicians

Objectives: Observation units (OUs) are widely used to care for adults, but little is published about their use in pediatrics. During the planning stages of our pediatric OU, community primary medical doctors (PMDs) expressed concerns about not admitting and managing their own patients in this unit controlled by pediatric emergency physicians. This study surveyed PMDs to determine their satisfaction with the pediatric OU two and a half years after opening. Methods: A satisfaction survey was mailed to pediatricians, family practitioners, and pediatric subspecialists whose patients had been admitted to the study pediatric OU from August 1999 to January 2002. A Likert scale ranging I to 4 was used to measure satisfaction in 4 areas. In addition, there were questions regarding the utility of the OU for treatment of common pediatric illnesses. Results: 198 of 248 (80%) surveys were returned. Pediatricians (64%) and family practitioners (23%) were represented most often. Fifty-three percent of PMD respondents had 10 or more patients admitted during the study period. Median satisfaction scores were 4 (most satisfied) in all areas measured. Over 60% of physicians surveyed felt that the OU was useful in the treatment of dehydration, gastroenteritis, reactive airway disease, and bronchiolitis. Conclusions: The model of an ED-controlled pediatric observation unit received high satisfaction ratings in all areas by community and subspecialty physicians two and a half years after opening. The initial reservations voiced by community physicians have not resurfaced.