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Improving Pediatric Readiness in General Emergency Departments: A Prospective Interventional Study
Kamal Abulebda1, Travis Whitfill2, Erin E Montgomery3
1Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine and Riley Hospital for Children at Indiana University Health, Indianapolis, IN.
Insights
A collaborative intervention improved pediatric readiness in general emergency departments (EDs). This national effort enhanced the weighted pediatric readiness score (WPRS), demonstrating the effectiveness of academic medical center partnerships.
Area of Science:
- Emergency Medicine
- Pediatric Care
- Quality Improvement
Background:
- General emergency departments (EDs) often lack specialized pediatric readiness.
- Improving pediatric readiness is crucial for optimal care of critically ill or injured children.
- A collaborative intervention model was designed to address these gaps.
Purpose of the Study:
- To evaluate the impact of a national collaborative intervention on pediatric readiness in general EDs.
- To assess changes in the weighted pediatric readiness score (WPRS) following the intervention.
- To identify specific domains of pediatric readiness that improved.
Main Methods:
- A prospective, multicenter, interventional study design was employed.
- Pediatric readiness was measured using the WPRS (0-100 scale) before and after a 6-month intervention.
- Interventions included benchmarking, resource toolkits, and academic medical center partnerships.
Main Results:
- Thirty-four general EDs completed the study, showing a mean WPRS improvement of 16.3 points (P < .001).
- Baseline WPRS averaged 62.4, increasing to 78.7 post-intervention.
- Significant improvements were noted in administration, policies, protocols, and quality improvement domains.
Conclusions:
- A collaborative intervention model effectively improved pediatric readiness in general EDs.
- Partnerships with regional pediatric academic medical centers facilitated this improvement.
- This strategy enhances pediatric readiness and care processes in diverse ED settings.
Objective:
To describe the impact of a national interventional collaborative on pediatric readiness within general emergency departments (EDs).
Study Design:
A prospective, multicenter, interventional study measured pediatric readiness in general EDs before and after participation in a pediatric readiness improvement intervention. Pediatric readiness was assessed using the weighted pediatric readiness score (WPRS) on a 100-point scale. The study protocol extended over 6 months and involved 3 phases: (1) a baseline on-site assessment of pediatric readiness and simulated quality of care; (2) pediatric readiness interventions; and (3) a follow-up on-site assessment of WPRS. The intervention phase included a benchmarking performance report, resources toolkits, and ongoing interactions between general EDs and academic medical centers.
Results:
Thirty-six general EDs were enrolled, and 34 (94%) completed the study. Four EDs (11%) were located in Canada, and the rest were in the US. The mean improvement in WPRS was 16.3 (P < .001) from a baseline of 62.4 (SEM = 2.2) to 78.7 (SEM = 2.1), with significant improvement in the domains of administration/coordination of care; policies, protocol, and procedures; and quality improvement. Six EDs (17%) were fully adherent to the protocol timeline.
Conclusions:
Implementing a collaborative intervention model including simulation and quality improvement initiatives is associated with improvement in WPRS when disseminated to a diverse group of general EDs partnering with their regional pediatric academic medical centers. This work provides evidence that innovative collaboration facilitated by academic medical centers can serve as an effective strategy to improve pediatric readiness and processes of care.
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