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Ann Emerg Med. 2016 Mar;67(3):320-328.e1. doi: 10.1016/j.annemergmed.2015.07.500. Epub 2015 Aug 29.

Pediatric Readiness and Facility Verification.

Author information

1
Austin-Travis County EMS System, Office of the Medical Director, and the Dell Children's Medical Center, Austin, TX. Electronic address: kate.remick@austintexas.gov.
2
Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA; Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA.
3
University of Utah Department of Pediatrics, National EMSC Data Analysis Resource Center, Salt Lake City, UT.
4
Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA; Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA; UCLA School of Nursing, Los Angeles, CA.
5
EMSC and Injury Prevention, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD.
6
Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA; Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA; Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA.

Abstract

STUDY OBJECTIVE:

We perform a needs assessment of pediatric readiness, using a novel scoring system in California emergency departments (EDs), and determine the effect of pediatric verification processes on pediatric readiness.

METHODS:

ED nurse managers from all 335 acute care hospital EDs in California were sent a 60-question Web-based assessment. A weighted pediatric readiness score (WPRS), using a 100-point scale, and gap analysis were calculated for each participating ED.

RESULTS:

Nurse managers from 90% (300/335) of EDs completed the Web-based assessment, including 51 pediatric verified EDs, 67 designated trauma centers, and 31 EDs assessed for pediatric capabilities. Most pediatric visits (87%) occurred in nonchildren's hospitals. The overall median WPRS was 69 (interquartile ratio [IQR] 57.7, 85.9). Pediatric verified EDs had a higher WPRS (89.6; IQR 84.1, 94.1) compared with nonverified EDs (65.5; IQR 55.5, 76.3) and EDs assessed for pediatric capabilities (70.7; IQR 57.4, 88.9). When verification status and ED volume were controlled for, trauma center designation was not predictive of an increase in the WPRS. Forty-three percent of EDs reported the presence of a quality improvement plan that included pediatric elements, and 53% reported a pediatric emergency care coordinator. When coordinator and quality improvement plan were controlled for, the presence of at least 1 pediatric emergency care coordinator was associated with a higher WPRS (85; IQR 75, 93.1) versus EDs without a coordinator (58; IQR 50.1, 66.9), and the presence of a quality improvement plan was associated with a higher WPRS (88; IQR 76.7, 95) compared with that of hospitals without a plan (62; IQR 51.2, 68.7). Of pediatric verified EDs, 92% had a quality improvement plan for pediatric emergency care and 96% had a pediatric emergency care coordinator.

CONCLUSION:

We report on the first comprehensive statewide assessment of "pediatric readiness" in EDs according to the 2009 "Guidelines for Care of Children in the Emergency Department." The presence of a pediatric readiness verification process, pediatric emergency care coordinator, and quality improvement plan for pediatric emergency care was associated with higher levels of pediatric readiness.

[Indexed for MEDLINE]

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