Table 4 Process and clinical outcomes

Primary Process Outcome

Completed CP on relevant patient charts

1) Initial: CP started; little or no documentation;

2) Partial: some but incomplete documentation; or

3) Full: meets requirements for CP success

Secondary Process Outcomes

CP use based on ED busyness

CP use for relevant patients, adjusted for shift-level ED data [66].

Primary Clinical Outcomes

Proportion of pediatric patients with asthma and V&D who received appropriate treatment, based on CP Key Interventions

Asthma CP: Treatment with corticosteroids [35, 36, 67, 68] in the ED and at discharge, defined as:

i). Patients with moderate to severe exacerbation are treated with systemic corticosteroids in the ED, and systemic plus inhaled corticosteroids at discharge,

ii). Patients with mild exacerbation are treated with either inhaled or oral corticosteroids at discharge.

V&D CP: Appropriate treatment with oral rehydration therapy (ORT), [37, 39] defined as:

i). Patients with moderate to severe dehydration are treated with ORT, and

ii). Patients with no to mild dehydration are not treated with ORT.

Secondary Clinical Outcomes

Proportion of pediatric patients with asthma and V&D who received appropriate assessment or treatment, based on CP Key Interventions Patient specific outcomes

Asthma CP:

Documentation of a Pre-school Respiratory Assessment Measure (PRAM) score [69–71].

V&D CP:

1) Documentation of a Gorelick score [37] for dehydration; and

2) Proportion of children treated with intravenous therapy for rehydration [39].

Both CPs: EDLOS, admission to hospital and re-visits to the ED within 72 hours.