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Pediatric ED

Progress on Pediatric Readiness in EDs Continues

By Jonathan Springston, Editor, Relias Media

The recently released results of a national survey suggested that despite the COVID-19 pandemic, U.S. emergency departments (EDs) have steadily improved their adherence to an ongoing quality improvement (QI) project over the last decade.

In 2021, researchers sent surveys to 5,150 EDs to gauge how well those departments are following the guidelines outlined in the National Pediatric Readiness Project (NPRP), a long-term effort to improve emergency care for children. A total of 3,647 departments responded, with 3,557 available for full analysis.

Leaders answered dozens of questions about staffing (especially the presence of pediatric emergency care coordinators), relevant training and certifications, specialized equipment and units, policies and procedures, ongoing QI plans, and more. Investigators used these data to create a weighted pediatric readiness score (WPRS; range, 0-100, with higher scores indicating better readiness).

The authors reported the median WPRS was 69.5, which they considered an improvement, albeit not significant, from the last assessment conducted in 2013. “Comparing commonalities between the two assessments, we see improvement in five of six categories,” said Kate Remick, MD, the study’s lead author and co-director of the NPRP. “This is especially positive given EDs were navigating the pandemic at the time of the survey.”

Still, Remick and colleagues noted the 69.5 mean WPRS is below a median of 88, a minimum score the authors said is associated with more improvements in pediatric survival rates. Other investigators have concurred that better adherence to the NPRP guidelines leads to better outcomes for young patients.

Remick and colleagues underlined a decline in one of the six categories: designating pediatric emergency care coordinators. Ideally, NPRP suggests a physician and a nurse should be appointed to this role. However, the 2021 survey indicated 37.3% of responders assigned a physician coordinator and 37.4% a nurse coordinator. Previous reports indicated 48% of responders had appointed a physician coordinator and 59% a nurse coordinator.

“Although the role of the [coordinator] is central to improving pediatric readiness, stressors on the healthcare sector and its workforce have undoubtedly played a role in reducing the assignment of physician and nurse personnel to this role,” the authors concluded. “This comprehensive assessment found that the presence of [coordinators], QI plans for children, and staffing the ED with board-certified [emergency and pediatric emergency] physicians were associated with higher pediatric readiness and provides an opportunity for all EDs to initiate organizational changes that can enhance their pediatric capability.”

Is your facility pediatric-ready? Click here to find out. For more on this and related subjects, be sure to read the latest issues of ED Management, Emergency Medicine Reports, and Pediatric Emergency Medicine Reports. For even more information, check out the latest installment in an award-winning series, Pediatric Trauma 2023: Practical Applications for High-Quality Care.