Abstract
Purpose: The purpose of this quality improvement (QI) project was to decrease LOS and improve patient satisfaction in a midwestern, freestanding pediatric urgent care (UC) by encouraging enrollment in the health system’s online patient portal system and by utilizing a paperless, electronic discharge process. Further, patient barriers for declining portal enrollment were determined.|Background: In the pediatric UC setting, delays in the discharge process contribute to overcrowding, increased LOS, and patient dissatisfaction. The patient portal, which provides unlimited access to health information, appears to be a useful technology that enhances care in the pediatric setting.|Sample/Setting: All patients seen and discharged in a 16-bed midwestern, freestanding pediatric UC from August 23, 2021-November 1, 2021.|Methods: Families were offered enrollment two different times (with access representatives or nurses) during the UC visit. Educational posters describing benefits of the portal system were displayed throughout the UC. Data analysis was completed using LOS (minutes in the UC) for portal versus non-portal users and responses from the National Research Corporation satisfaction surveys. Qualitative data helped determine reason for declining enrollment. Data was retrieved to determine if patients accessed instructions online after discharge.|Results: 311 patients were enrolled in the portal. Average LOS for portal users was 76.71 minutes compared to 93.83 minutes of non-portal users, a 17.12-minute difference. Portal users reported higher satisfaction rates when looking at overall UC experience and timeliness for being seen compared to non-portal users. 16% of those surveyed identified limited access to technology as the reason for declining enrollment. Discharge instructions were accessed in the portal 16% of time.|Conclusion: UC portal enrollment allows for expedited discharge which reduced LOS and improved satisfaction rates. Further research on promoting patient use of portal discharge instructions and addressing barriers for accessing technology is necessary to promote future patient portal usage.