The Association of Emergency Department Weighted Pediatric Readiness Score with Pediatric Inpatient Capabilities

Prior studies show emergency departments (EDs) with high pediatric readiness, measured by the weighted pediatric readiness score (WPRS), are associated with lower pediatric mortality from critical illness and injury. However, associations between hospital inpatient pediatric capabilities and ED pediatric readiness have not been studied.

Our aim was to examine the relationship between inpatient pediatric capabilities and ED WPRS.

Retrospective cross-sectional study with secondary analysis of the 2021 National Pediatric Readiness Project (NPRP) assessment results. Hospital inpatient capabilities were analyzed in combinations of pediatric inpatient units (inpatient, nursery, pediatric intensive care unit, neonatal intensive care unit, adult unit admitting children) and WPRS. Univariable regression models were used to evaluate the relationship between WPRS and volume, ED type, and inpatient capability.

3495 assessments with complete inpatient and scored data were analyzed. Hospitals reporting all pediatric inpatient capability and containing a separate pediatric ED had the highest WPRS (n = 205, median 96.0, [interquartile range (IQR) 87.0, 98.5]). Hospitals with adult units that could admit children had a median WPRS of 61.0 (N = 546, [IQR 53.4, 75.5]). The largest hospital grouping, non-children's hospitals without a separate pediatric ED and no pediatric inpatient capability (N = 804), had a median WPRS of 67.2 [IQR 58.4, 79.8]. Higher inpatient capability showed an overall trend in increased median WPRS with addition of each inpatient unit type.

The presence of both a pediatric ED space and all hospital inpatient pediatric capabilities is associated with the highest WPRS. Having pediatric ED space is associated with higher WPRS than any specific pediatric inpatient unit.