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Pediatría (Asunción)

versão On-line ISSN 1683-9803


MORILLA, Laura; CARDOZO, Natalia  e  PAVLICIH, Viviana. Implementation of a Balanced Scorecard in a pediatric emergency department. Pediatr. (Asunción) [online]. 2015, vol.42, n.2, pp.108-114. ISSN 1683-9803.

Introduction: The introduction of Balanced Scorecards in a Pediatric Emergency Department (PED) has proven useful as a management and quality control tool. Objective Analyze the quality and activity in a PED by applying a Balanced Scorecard. Material and Methods: Retrospective review of 45,983 consultations from January to July 2014 in the Balanced Scorecard database. We reviewed indicators for triage classification, global care and utilization measures, and visit times.  We validated the triage system by reviewing hospitalization rates, resource utilization, and length-of-stay compared to the initial classification levels.  and care of the global query area were reviewed. Results: The average waiting time for Triage (TWT) was 6.6 minutes, with 90% of cases waiting less than 10 minutes. The average duration of triage was 1.5 minutes. The PED tracking system showed 68.7% of patients classified as levels IV and V (31,608) and 31.3% of patients as Levels I, II, and III (14,375). The revaluation rate was 0.5% and 4.5% left without being seen (0.14% pre triage, 3.2% post-triage and  1.2% post evaluation). 90% of patients who left without being seen were classified as non-critical patients. The average length-of-stay was within the standard maximum time allowed for the physician consultation. A comparison of resource utilization between the critical levels (II, III) and non-critical levels (IV, V) to include laboratory studies (13.1 vs 8.9, p = 0.005), imaging studies (10.7 vs 5.5, p = 0.005), hospitalization rates and length-of-stay were consistent with the assigned triage level. The overall mortality rate was 0.01%. Conclusion: The development of a Balanced Scorecard allowed quality and activity reviews, providing data on the day-to-day operations of the PED that led to improvements in utilization of human and physical resources.

Palavras-chave : Balanced Scorecard; quality control; standards of care; pediatric emergencies.

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