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Emergency Department Pediatric Readiness and Potentially Avoidable Transfers
Monica K Lieng1, James P Marcin1, Parul Dayal1
1Department of Pediatrics, University of California, Davis Health, Sacramento, CA.
Higher pediatric readiness in emergency departments (EDs) is linked to fewer potentially avoidable transfers (PATs) for children. Improving specific readiness components can help reduce these transfers.
Area of Science:
- Pediatric Emergency Medicine
- Healthcare Quality Improvement
- Health Services Research
Background:
- Potentially avoidable transfers (PATs) represent suboptimal care coordination for pediatric patients.
- Assessing emergency department (ED) pediatric readiness is crucial for evaluating care quality.
Purpose of the Study:
- To investigate the association between pediatric readiness scores in EDs and the occurrence of PATs.
- To identify specific components of ED pediatric readiness that may influence PAT rates.
Main Methods:
- Cross-sectional study linking California ED/inpatient data (2011-2013) with the 2012 National Pediatric Readiness Project assessment.
- Defined PATs based on discharge timing and absence of specialized procedures.
- Used mixed-effects logistic regression to compare PATs with necessary transfers, adjusting for covariates.
Main Results:
- A 10-point increase in pediatric readiness was associated with reduced odds of PATs for both injured and non-injured children.
- Adjusted analyses confirmed this association for injured children but not for non-injured children.
- Having a nurse pediatric emergency care coordinator and a quality improvement plan were linked to fewer PATs.
Conclusions:
- Enhanced pediatric readiness in hospital EDs correlates with a lower likelihood of PATs.
- Specific, modifiable pediatric readiness components offer targets for interventions aimed at reducing PATs.
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