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Enhancing Prehospital Care for Medically Complex Children: The Evolution of the STARS Program.

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Summary

The Special Needs Tracking and Awareness Response System (STARS) improves emergency medical services (EMS) for children with medical complexity (CMC). This program enhances EMS readiness and promotes health equity for vulnerable pediatric populations.

Keywords:
children with medical complexitydisabilitiesdisaster preparednessemergency medicineprehospitaltransport medicine

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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.