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J Pediatr. 2019 Nov 19. pii: S0022-3476(19)31340-X. doi: 10.1016/j.jpeds.2019.10.017. [Epub ahead of print]

Statewide Pediatric Facility Recognition Programs and Their Association with Pediatric Readiness in Emergency Departments in the United States.

Author information

1
Departments of Pediatrics and Emergency Medicine, Yale School of Medicine, New Haven, CT. Electronic address: travis.whitfill@yale.edu.
2
Office of the Medical Director, Austin-Travis County EMS System, Austin, TX; Dell Medical School at the University of Texas, Austin, TX; San Marcos/Hays County EMS System, San Marcos, TX; EMS for Children Innovation and Improvement Center, Houston, TX.
3
National Emergency Medical Services for Children Data Analysis Resource Center, Department of Pediatrics, Division of Critical Care, University of Utah, Salt Lake City, UT.
4
Department of Emergency Medicine, The George Washington University School of Medicine, Washington, DC; Children's National Medical Center, Washington, DC.
5
Departments of Pediatrics and Emergency Medicine, Yale School of Medicine, New Haven, CT.
6
Departments of Emergency Medicine and Pediatrics, Harbor-UCLA Medical Center, Torrance, CA; Departments of Emergency Medicine and Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA; Emergency Medical Services Agency, Department of Health Services, Los Angeles County, Los Angeles, CA.

Abstract

OBJECTIVE:

To describe the relationship between statewide pediatric facility recognition (PFR) programs and pediatric readiness in emergency departments (EDs) in the US.

STUDY DESIGN:

Data were extracted from the 2013 National Pediatric Readiness Project assessment (4083 EDs). Pediatric readiness was assessed using the weighted pediatric readiness score (WPRS) based on a 100-point scale. Descriptive statistics were used to compare WPRS between recognized and nonrecognized EDs and between states with or without a PFR program. A linear mixed model with WPRS was used to evaluate state PFR programs on pediatric readiness.

RESULTS:

Eight states were identified with a PFR program. EDs in states with a PFR program had a higher WPRS compared with states without a PFR program (overall a 9.1-point higher median WPRS; P < .001); EDs recognized in a PFR program had a 21.7-point higher median WPRS compared with nonrecognized EDs (P < .001); and between states with a statewide PFR program, there was high variability of participation within the states. We found state-level PFR programs predicted a higher WPRS compared with states without a PFR program (β = 5.49; 95% CI 2.76-8.23).

CONCLUSIONS:

Statewide PFR programs are based on national guidelines and identify those EDs that adhere to a standard level of readiness for children. These statewide PFR initiatives are associated with higher pediatric readiness. As scalable strategies are needed to improve emergency care for children, our study suggests that statewide PFR programs may be one way to improve pediatric readiness and underscores the need for further implementation and evaluation.

KEYWORDS:

EMSC; emergency medicine; facility recognition; pediatric readiness

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