The story of Pediatric Emergency Medicine at Emory University and Children’s Healthcare of Atlanta at Egleston and Hughes Spalding

 

by Wendy Little (wendalyn.little@emory.edu)

Children’s Healthcare of Atlanta is one of the largest and busiest pediatric healthcare systems in the United States. The three CHOA emergency departments collectively encounter over 200,000 visits per year and the hospitals, with their full complement of pediatric subspecialty providers, care for some of the sickest and most medically complex patients in the state and the region. While specialized pediatric healthcare in Atlanta dates back to the early 1900s, there were no pediatric emergency departments and no pediatric emergency specialists in Atlanta until the mid 1980’s The growth of emergency medical care for children in Atlanta over the past 30 years has been phenomenal!

The Henrietta Egleston Hospital for Children was founded in 1928. Thomas R. Egleston Jr, a wealthy Atlantan, left money in his will for the founding of a children’s hospital to be named after his mother, Henrietta Egleston. The first Egleston hospital was located in Atlanta on what is now Ralph Magill Avenue. In 1956 Emory University donated land for an expanded facility on the Emory campus, thus beginning the long standing relationship between Emory University and Egleston. The “new” Egleston Children’s Hospital on Clifton Road opened in 1959.

Pediatric emergency medicine did not begin to emerge as a specialty until the latter part of the 20th century.  In 1984 the first Acute Treatment Area was opened at Egleston Children’s Hospital. This area had 2 examination rooms and a four bed holding area. It was initially open for 9 hours overnight on weekdays and 24 hours per day on weekends, and saw approximately 8800 patients per year. Patients could not walk-into the facility but had to be referred by a physician. In 1986 Egleston became a Level 2 pediatric trauma center and in 1988 the Emergency Department began accepting walk-in patients and transitioned to 24-hour physician coverage.

CHOA Egleston has expanded several times since it was first built, most recently in 2007. It now boasts 255 inpatient beds, over 10,000 admissions per year, a 30 bed pediatric intensive care unit and a 40 bed emergency department with over 70,000 ED visits per year. In 2009 CHOA Egleston became the first and only Level 1 Pediatric Trauma Center in the state of Georgia.

The Hughes Spalding Pavilion opened in 1952 as a private hospital on the campus of Grady Memorial Hospital that served African-American patients. The hospital served a variety of functions through 1989. Until 1992, pediatric patients were first seen in a 24-hour walk-in clinic on the second floor of Grady staffed mainly by Emory pediatric residents. It was a busy place, seeing over 60,000 patients per year; wait times were notoriously long, with patients routinely waiting over 12 hours to be seen. In 1992 Hughes Spalding was re-opened as a dedicated pediatric facility, including an emergency department consisting of a 6-bed observation room, an asthma room with chairs to accommodate approximately 10 patients, 3 private emergency department rooms, an urgent care/clinic area and a single resuscitation room. In 2006 Children’s Healthcare of Atlanta assumed clinical operations at Hughes Spalding. CHOA at Hughes Spalding underwent a major renovation in 2010. The updated facility included a new emergency department with 32 private rooms. The Hughes Spalding Emergency Department remains a busy place with over 50,000 patient visits per year and is staffed by PEM physicians and fellows as well as residents from a variety of training programs through Emory and Morehouse Schools of Medicine.

Pediatric Emergency Medicine is a relatively new specialty. The longest running fellowship was established in 1980. Emergency Medical Services for Children (EMS-C) was established in 1984. The first board subspecialty exam was administered in 1992. In 1998 Pediatric Emergency Medicine Fellowships became accredited. There are just over 1700 Pediatric Emergency Medicine board certified physicians in the country and 68 in the State of Georgia. The growth of the Emory PEM division and Emergency Medicine at Children’s Healthcare of Atlanta has mirrored the rapid growth of the specialty itself in just over 30 years:

-A division of 4 has become a division of more than 40 physicians (PEM and UC Physicians)

-The Emergency Department at Egleston has gone from an annual volume of 8800 to over 70,000 visits in 2016 with 15% EMS visits.

– The Emergency Department at Hughes Spalding continues to see a high volume (>52,000 patients in 2016 with 11% EMS visits) of patients, but now does so much more efficiently with a dedicated pediatric facility, improved staffing and an electronic medical record system.

-Our physicians staff 2 of 3 Emergency Departments at Children’s Healthcare of Atlanta, one of the biggest and busiest pediatric healthcare systems in the United States

-Egleston is the only Level 1 Pediatric Trauma Center in the state of Georgia and a referral center for patients throughout the state and the region

-Our PEM fellowship has grown from 1 fellow to 9 fellows and boasts an excellent clinical and research/scholarly experience for our trainees

-Finally we have an excellent clinical faculty with strong commitments to teaching and research.

 

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