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Hello from the other end of the world,

I need your advice. I manage an Emergency Department with a separate Peds 
(Children's Hospital) and adult (Main Hospital) Emergency Divisions, with a 
total of 110000 visits/yr,  in a large medical complex of four adjacent 
hospitals: Main, Children's, Women's, and Rehab. Our administration has 
approved building a new and much larger ED on a piece of land next to the 
Main Hospital which is about 150 m away from Children's Hospital. The space 
allocated to the new ED is 7000m2 and will have a separate adults and Peds 
EDs under one roof, plus a 1500m2 short stay unit on the second floor. There 
will be a corridor that will connect the new ED to Main and Children's Hospital.

Some of our group and the Pediatric specialists raised concern over the 
somewhat long distance that separate Children's Hospital from the new ED 
location and suggested rather to expand the current small Peds ED which is in 
Children's Hospital, and have the new ED serve adults.

The advantage as we see it of keeping the Peds ED in Children's Hospital is 
the easy access to the Hospital and separating  completely sick adults from 
Children. The disadvantages are the extra construction and operation cost, 
the difficulty in managing 2 separate EDs.

Your advice will be highly appreciated.

Yours,

Saleh Altamimi, MD
Consultant, Pediatric Emergency
Director of Emergency Medicine
King Fahad Medical City, Riyadh

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The URL for the PED-EM-L Web Page is:
  http://www.brown.edu/Administration/Emergency_Medicine/ped-em-l.html