Background Redirection of non-urgent patient visits from the pediatric emergency department (ED) to community healthcare professionals may reduce crowding. As there is no consensus about who should be eligible for redirection, this qualitative study explored how health professionals conceptualize eligibility for pediatric redirection. Methods We completed one-on-one semi-structured interviews with pediatric ED triage nurses and physicians, office-based pediatricians and family physicians, and healthcare leaders who oversee pediatric and ED operations. Interviews were recorded, transcribed, and analyzed using reflexive thematic analysis within an interpretive description framework to generate clinically relevant insights. Results From our 24 interviews (6 community professionals, 11 pediatric ED professionals, and 7 healthcare leaders), we identified three guiding principles that are important to consider when developing eligibility criteria: 1. assessing the impact of presenting condition on the patient and caregivers; 2. medical complexity of the clinical condition, patient, and health system; and 3. process-related considerations. Conclusion This study captures referring and receiving healthcare professional perspectives about eligibility for pediatric ED redirection. The resulting guiding principles support prior work that focuses on patient characteristics and medical complexity, and also emphasizes the importance of considering family capacity, patient history, and shared decision making when creating pediatric redirection eligibility criteria. Impact <UnorderedList Mark="Bullet"> <ItemContent> Through interviews with referring and receiving healthcare professionals and health leaders, we identified guiding principles that can support identifying patients suitable for redirection from the pediatric ED. </ItemContent> <ItemContent> The guiding principles we developed provide a structured, healthcare professional-informed foundation to determine which children may be suitable for ED redirection and highlight the importance of caregiver, health system, and process factors often overlooked in prior approaches. </ItemContent> <ItemContent> Our guiding principles reflect health professionals’ values surrounding redirection and if applied can enhance the acceptability and sustainability of pediatric ED redirection programs. </ItemContent> </UnorderedList>

Eligibility for redirection from the pediatric emergency department: a qualitative study of professional and leader perspectives

期刊论文
发表日期：

2026年3月30日

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Erica Qureshi,
Quynh Doan,
Linda Chen,
Garth Meckler,
Brett Burstein,
Jessica Moe,
Steven P. Miller,
Jehannine Austin

摘要

Background

Redirection of non-urgent patient visits from the pediatric emergency department (ED) to community healthcare professionals may reduce crowding. As there is no consensus about who should be eligible for redirection, this qualitative study explored how health professionals conceptualize eligibility for pediatric redirection.

Methods

We completed one-on-one semi-structured interviews with pediatric ED triage nurses and physicians, office-based pediatricians and family physicians, and healthcare leaders who oversee pediatric and ED operations. Interviews were recorded, transcribed, and analyzed using reflexive thematic analysis within an interpretive description framework to generate clinically relevant insights.

Results

From our 24 interviews (6 community professionals, 11 pediatric ED professionals, and 7 healthcare leaders), we identified three guiding principles that are important to consider when developing eligibility criteria: 1. assessing the impact of presenting condition on the patient and caregivers; 2. medical complexity of the clinical condition, patient, and health system; and 3. process-related considerations.

Conclusion

This study captures referring and receiving healthcare professional perspectives about eligibility for pediatric ED redirection. The resulting guiding principles support prior work that focuses on patient characteristics and medical complexity, and also emphasizes the importance of considering family capacity, patient history, and shared decision making when creating pediatric redirection eligibility criteria.

Impact

Through interviews with referring and receiving healthcare professionals and health leaders, we identified guiding principles that can support identifying patients suitable for redirection from the pediatric ED.

The guiding principles we developed provide a structured, healthcare professional-informed foundation to determine which children may be suitable for ED redirection and highlight the importance of caregiver, health system, and process factors often overlooked in prior approaches.

Our guiding principles reflect health professionals’ values surrounding redirection and if applied can enhance the acceptability and sustainability of pediatric ED redirection programs.