Most children in the US seek emergency care in general emergency departments (EDs) that evaluate both children and adults. Some EDs are well prepared to care for children, whereas others have variable access to pediatric-specific resources, resulting in barriers to optimal pediatric emergency care delivery. 1 Over the past 2 decades, major efforts have been made to measure and improve pediatric readiness across EDs. 1 The weighted Pediatric Readiness Score (wPRS) serves as a measure of adherence to 6 domains of pediatric emergency care: coordination of care, physician and nurse staffing, quality improvement, patient safety, policies and procedures, and equipment and supplies. 1 Prior literature has demonstrated that a high wPRS is associated with improved mortality among 2 distinct groups of children: critically ill children 2 and children with injuries presenting to trauma centers. 3 However, it is unknown whether the mortality benefits of high ED pediatric readiness extend to all children or whether these mortality benefits for all children are sustained beyond the immediate care period.Newgard et al 4 found that high ED pediatric readiness is associated with both short-term and longterm mortality benefits for children. This retrospective cohort study was conducted over 6 years and included 796 937 children across 983 EDs in 11 states. 4 Pediatric readiness was measured using the wPRS, derived from a national assessment of EDs performed in 2013. 1 The primary outcome was inhospital mortality. Six states had longitudinal data available, allowing for evaluation of mortality at 1-year from the index ED visit. Children presenting for injuries and medical conditions were analyzed as separate cohorts using patient-level mixed effects logistic regression models. Prespecified subgroup analyses were performed by clinical condition, severity of illness, age group, and transfer status.The findings of the study are striking: provision of care in EDs with the highest quartile wPRS (quartile 4, wPRS Ն88) compared with the lowest quartile wPRS (quartile 1, wPRS Յ58) was associated with a 60% reduction in mortality for the injury cohort and a 76% reduction in mortality for the medical cohort. 4 Remarkably, an estimated 1442 pediatric deaths could have been prevented if all lower readiness EDs (quartiles 1-3) had performed similarly to high readiness EDs (quartile 4). 4 These findings remained consistent after adjusting for hospital-level variables, including annual pediatric ED volume, annual pediatric admission volume, presence of a separate pediatric ED, hospital type, and trauma center designation level. When examining 1-year outcomes, the injury and medical cohorts had a 41% (adjusted hazard ratio, 0.59) and 66% (adjusted hazard ratio, 0.34) reduction in risk of death, respectively, in high readiness EDs (quartile 4 vs quartile 1). 4 Results from this groundbreaking study 4 invoke a call to action to improve pediatric readiness among all EDs that provide emergency care to children. Additionally, the study establishes a spe...