Utilization of a pediatric emergency department by patients with sickle cell disease

When considering an alternative site to the emergency department (ED) for the care of acutely ill patients with sickle cell disease, it is necessary first to determine utilization of and satisfaction with ED care. Such data serve as guidelines for the planning and evaluation of alternative treatment facilities. We reviewed 137 consecutive ED visits by 98 patients with sickle cell disease at The Children's Hospital of Philadelphia over a three-month period to determine ED utilization and waiting times. A follow-up telephone survey determined reasons for coming to the ED, duration of symptoms, and patient satisfaction with the ED visit. Our results reveal that an alternative facility open only during regular working hours would not serve the majority of patients with sickle cell disease. We describe the services provided to acutely ill sickle cell disease patients, and identify areas for improved service delivery within our ED or an alternative facility.