Enhancing Prehospital Care for Children with Medical Complexity: The Evolution of the STARS Program

Area of Science:

• Pediatric Emergency Medicine
• Health Informatics
• Public Health

Background:

• The population of children and youth with special health care needs (CYSHCN), including children with medical complexity (CMC), has grown significantly.
• Advances in medical care allow these children to live at home, increasing their likelihood of requiring emergency medical services (EMS).
• EMS clinicians often have limited pediatric training and infrequent encounters with CMC, leading to variable preparedness and comfort.

Purpose of the Study:

• To develop and implement a system to enhance EMS readiness for CMC.
• To promote health equity and improve prehospital care for CMC.
• To address gaps in emergency care for medically complex pediatric populations.

Main Methods:

• STARS, launched in 2014, evolved into a hospital-based, physician-led program.
• Individualized emergency care plans are stored in a secure electronic system.
• A key component involves providing emergency care education to EMS and community emergency departments.

Main Results:

• As of 2025, STARS has enrolled 2424 patients.
• The program has demonstrated success in reducing unnecessary transports.
• STARS has strengthened disaster response capabilities and addressed health inequities in CMC.

Conclusions:

• STARS offers a scalable, collaborative model for high-risk pediatric populations.
• The system prioritizes targeted EMS training and interdisciplinary care coordination.
• Real-time access to patient-specific plans advances prehospital care and improves health outcomes for CMC.