development, implementation, and evaluation of structured performa in the initial assessment of sick children at the emergency department: a third level kirkpatrick’s evaluation model

Background & objective: at emergency department (ed) at different point of time different teams are involved in management of patients as per their posting/duty roster. so, a robust system should be in place to avoid major mishaps. the current study was an attempt to improve pediatric care at our emergency department through third-level kirkpatrick’s evaluation model after training of pediatric resident doctors to use newly developed structured proforma while doing initial assessment of sick children at ed. materials & methods: this quasi-experimental study included all departmental pediatric resident doctors and as per sample size calculation, 36 (pre-intervention) and 36 (post-intervention) computer-generated random selection records were reviewed from the total of serially arranged admissions of pediatric patients. the intervention was the implementation of a structured proforma, and training of all departmental residents. all raters scored the records of patients on 47 & 51 items of documentation pre-and post-intervention periods respectively on a scale 0-2, 0 meaning ‘no mention’, 1-incomplete/improper mention and 2-complete/proper mention. mean, standard deviation (sd) of scores were calculated item-wise, raters-wise and overall. bland altman analysis was done to find agreement in scoring among raters both in preand post-intervention. results: the mean (sd) and percentage of mean score were 32.93 (4.50) and 35.03% before intervention whereas 89.64 (4.35) and 87.88% post-intervention. this indicated 53.5% improvement post-intervention. bland altman analysis found good agreement post-intervention. conclusion: the introduction of educational tool along with the training of pediatric resident doctors to implement it, has improved documentation process significantly.