Documentation of Pregnancy Options Counseling in a Pediatric Emergency Department and Outpatient General Pediatric Clinic: A Single-Center Retrospective Study

Abstract

We reviewed electronic health record documentation of outpatient and emergency department (ED) visits with a positive pregnancy test from January 1, 2014, to June 1, 2021, within a tertiary-care pediatric system for documentation of pregnancy options counseling. We excluded encounters where patients were admitted or referred/transferred to another ED, or nurse-only visits. Of 88 eligible encounters, 51/88 (58%) occurred in the ED and 37/88 (42%) in outpatient clinic. Options counseling was documented in 20 encounters (23%), including 6/51 (12%) of ED visits and 14/37 (38%) of clinic visits. By logistic regression adjusting for age, race, insurance type, and prior positive pregnancy test, options counseling documentation was significantly more likely for outpatient clinic visits than the ED (aOR = 4.80, 95% CI = 1.52-15.18, P = .008). Rates of documentation of options counseling in pediatric settings are low and are lower for ED than outpatient visits, suggesting low rates of options counseling in pediatric practice.