# Assessment of quality of care in a pediatric emergency unit of a tertiary hospital, Ethiopia

## TL;DR

This study evaluates the quality of pediatric emergency care at a hospital in Ethiopia, identifying areas needing improvement like diagnostic speed and rural access.

## Contribution

The study provides a detailed assessment of pediatric emergency care quality in a low-resource setting using a combined quality framework.

## Key findings

- Weight documentation rate was 97.6%, but laboratory turnaround time was 202 minutes.
- Parent/guardian satisfaction was 84.1%, with lower satisfaction linked to rural residential areas.
- Healthcare-associated infection rate was 2.8%, and imaging test completion rate was 11.1%.

## Abstract

Despite the critical importance of pediatric care in low-resource settings, characterized by limited infrastructure, scarce resources, and high patient volumes, the quality of care provided in these environments remains poorly understood. This study aimed to assess selected quality of care indicators in the pediatric emergency unit (PEU) of Tikur Anbessa Specialized Hospital (TASH).

A cross-sectional study was conducted among children aged 0–14 years who visited the PEU of TASH between January 1 and March 30, 2024. Participants were selected using a consecutive sampling technique. Data were collected using a quality indicator performance checklist, clinical record reviews, and a structured questionnaire administered to parents or guardians. Descriptive and correlation analyses were performed using SPSS version 26. Quality indicators were evaluated based on the combined framework of the Institute of Medicine’s (IOM) six quality domains—safety, effectiveness, patient-centeredness, timeliness, equity, and efficiency—and Donabedian’s structure–process–outcome model.

A total of 289 pediatric patients were included, with a median age of 48 months (IQR: 16.5–86.5 months). Key performance measurements showed a weight documentation rate of 97.6%, an unscheduled re-attendance rate of 13.5% within one month, a median laboratory turnaround time of 202 min (95% CI: 167–247), and an 11.1% in-house completion rate for imaging tests (specifically computed tomography scans). The healthcare-associated infection rate was 2.8%, caregiver-provider communication ranged from 77.5% to 92.7% across various aspects of care, and parent/guardian satisfaction was 84.1%. A significant negative correlation was found between parent/guardian satisfaction and residential address (r = − 0.120, p < 0.05).

Strengthening diagnostic turnaround times, improving discharge and follow-up systems, and ensuring equitable access for children from rural areas are essential to enhancing the overall quality of pediatric emergency care.

The online version contains supplementary material available at 10.1186/s12913-026-14100-5.