Background: Paediatric patients with complex care needs require emergency plans for timely and consistent care, particularly if travelling to a regional hospital from a rural/remote area. To improve waiting time (WT), patient care time (PCT) and total ED time (TEDT) of such patients, Canberra Hospital ED created innovative emergency identification cards (EICs) in late 2022. 

Objectives: To determine whether the EICs aided identification and treatment.

Methods:  Mixed methods study using chart review of all presentations by patients allocated an EIC in the regional ED who presented over 1-Dec-2013 to 1-Dec-2023 and telephone survey of guardians whose child received a card.

Results: 139 patients, median age 8, received an EIC and plan. 21% of primary residences were rural NSW. Of the 28 patients who made presentations before and after the EIC, median WT decreased from 1:01 to 0:20 (P=0.009, Wilcoxon signed rank) as patients were triaged to higher categories (P=0.005, Chi-squared) and more likely to be seen within triage threshold time (P=<0.0004, McNemar’s Chi). Median PCT increased non-significantly after the EIC, TEDT was unchanged and admission rate was lower across all presentations.

98 of 115 eligible guardians consented to interview (85%, 95%CI 77-91). 74% had a positive response to the EIC, 45% reported usage. Themes were improved treatment, advocacy and practicality. 11% were unsure of the card’s purpose. 13% felt staff training in card significance was inadequate. 

Conclusions: The EIC was associated with significantly improved patient outcomes. This innovation can be implemented at local rural and regional hospitals to advance care.