U.S. EDs are improving pediatric readiness: study

by Lauren Dubinsky, Senior Reporter | April 13, 2015
Emergency Medicine Pediatrics
Emergency departments around the U.S. have improved pediatric readiness based on self-reported online assessments evaluating compliance with national guidelines, according to a new study published online in JAMA Pediatrics.

The study was based on a 55-question web-based assessment taken by 4,137 EDs that represent about 24 million annual pediatric visits. The researchers found that the median weighted pediatric readiness score was 68.9, which is up from the score of 55 reported in 2003.

The study revealed that 47.5 percent of the EDs had a physician pediatric emergency care coordinator (PECC), 59.3 percent had a nurse PECC and 42 percent had both. The PECC is responsible for staff training, equipment availability and policies for child care.

Almost all of the EDs trained their staff on where the pediatric equipment is located in the ED but only about 45 percent reported that they had a quality improvement plan to address the needs of children. In addition, just under half of the EDs reported having a disaster plan specifically for children.

The lower-volume EDs reported that about 79 percent of the physicians caring for the children were family medicine-trained but the higher-volume EDs only reported 32 percent. Most of the physicians caring for children in the higher-volume EDs were trained in emergency medicine or pediatric emergency medicine.

The EDs also mentioned a few of the challenges they are experiencing. About 81 percent stated that there are hurdles to implementing readiness guidelines including the price of training — 54.4 percent — and the lack of educational resources — 49 percent.

Dr. Evaline A. Alessandrini of Cincinnati Children’s Hospital Medical Center and Dr. Joseph L. Wright of the Howard University College of Medicine wrote in a related editorial that performance measurement is important for the sake of transparency.

“Transparently reporting pediatric ED readiness scores to patients and the public holds health care professionals accountable to both consumers and purchasers of care; transparency builds trust,” they wrote. “Patients can also learn what the expected professional standards of care are and where they can go to receive them.”

But they did mention that when it comes to pediatric readiness, there is still a long way to go. They believe that the National Pediatric Readiness Project, which is a multi-phase quality improvement initiative to ensure that all U.S. EDs have the guidelines and resources to effectively care for children, “brings the field closer to a full-circle realization of the evidence parameters around which universal standards for the care of children in EDs can be implemented and ultimately linked to optimal outcomes.”

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