701 - Sustained Effects of Multi-Modal Educational Interventions on Pediatric Emergency Department Utilization Patterns

Publication Number: 3678.701

Destiny D. Kanning, Michigan State University College of Human Medicine, Grandville, MI, United States

Background: Emergency departments (EDs) across the U.S. face significant strain from non-emergent pediatric visits, often driven by caregiver confusion, limited access to after-hours care, and gaps in health literacy. These visits contribute to overcrowding, provider burnout, and misallocation of critical resources. Preliminary studies in Michigan suggest that community-informed educational interventions can address these patterns by equipping families with the tools to make informed care decisions.

Objective: To evaluate the long-term impact of layered, community-informed educational interventions on non-emergent pediatric ED utilization and caregiver health literacy.

Design/Methods: This prospective longitudinal study followed caregivers of pediatric patients at three urban Michigan hospitals between October 2022 and October 2025. Participants were enrolled at discharge after presenting for non-emergent concerns and received one or more educational interventions, including plain-language guides, in-person workshops, and discharge counseling. Surveys were administered at 1, 6, and 12 months to assess knowledge retention and care-seeking behavior. Quantitative data were analyzed using repeated measures ANOVA. Monthly ED utilization data and provider time allocation were also tracked. A subset of caregivers completed qualitative interviews.

Results: Among 523 participants, caregiver health literacy scores improved by 68.0777% at 1-month follow-up, with retention observed at 6 months. A 29.33% reduction in non-urgent ED visits was recorded, with the largest improvements seen in communities exposed to repeated interventions. Emergency clinicians reported a 22% decrease in time spent on non-emergent cases, corresponding to over 1,200 hours reallocated to high-acuity care. Interviews revealed increased caregiver confidence, though after-hours care navigation remained a challenge for some.

Conclusion(s): Educational interventions, when delivered consistently and in collaboration with community partners, can meaningfully reduce non-emergent ED utilization and improve caregiver decision-making. These findings support the integration of patient education into discharge protocols and public health strategies as a cost-effective, scalable approach to alleviate emergency department strain and promote family-centered care.

Knowledge Gains Following Educational Intervention
Self-reported understanding of healthcare services before and after participation in layered educational interventions among caregivers (n = 523). Greatest knowledge gains observed for telehealth, urgent care, and community-based services, suggesting improved care navigation capacity.

Longitudinal Trend of Pediatric ED Overutilization in Michigan
Monthly trends in non-emergent pediatric emergency department visits across six Michigan hospital systems and one out-of-state comparator from Jan 2023 to mid-2024. Spline smoothing applied to visualize reduction patterns following educational interventions. Declines are most notable at sites with repeated caregiver engagement initiatives.