Pediatric Readiness and Facility Verification

Remick, Katherine; Kaji, Amy H.; Olson, Lenora M.; Ely, Michael; Schmuhl, Patricia; McGrath, Nancy E.; Edgerton, Elizabeth A.; Gausche‐Hill, Marianne

doi:10.1016/j.annemergmed.2015.07.500

Cited by 95 publications

(105 citation statements)

References 18 publications

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“…Among CAHs in this study, approximately two‐thirds reported having a PECC whose role is to ensure guidelines and policies are implemented. The next level of strategy associated with increased readiness is participating in a pediatric readiness facility recognition program, which typically involves both assessment and verification of readiness . In this study, CAHs that participated in a pediatric facility recognition program had a higher WPRS by 20 points.…”

Section: Discussionmentioning

confidence: 84%

“…Cost‐effective demonstration projects show some success for increasing pediatric readiness. For example, pediatric facility recognition programs that ensure EDs meet the minimum pediatric standards through quality improvement initiatives and onsite verification in 11 states showed improved health outcomes among pediatric patients . Simulation trainings have been a cost‐effective tool used in CAHs to improve pediatric emergency care .…”

mentioning

confidence: 99%

“…For example, pediatric facility recognition programs that ensure EDs meet the minimum pediatric standards through quality improvement initiatives and onsite verification in 11 states showed improved health outcomes among pediatric patients. [16][17][18][19][20][21] Simulation trainings have been a costeffective tool used in CAHs to improve pediatric emergency care. 22 But overall, little data exist on pediatric emergency care focusing solely on CAHs and their unique characteristics.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Pediatric Readiness in Critical Access Hospital Emergency Departments

Pilkey

Edwards

Richards

et al. 2018

The Journal of Rural Health

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Section: Discussionmentioning

confidence: 84%

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confidence: 99%

mentioning

confidence: 99%

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Pediatric Readiness in Critical Access Hospital Emergency Departments

Pilkey

Edwards

Richards

et al. 2018

The Journal of Rural Health

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“…Although there have been improvements in pediatric readiness of all EDs over the past decade, there remain opportunities for more EDs to become compliant with national guidelines. Only 12% of California-based hospitals and 10% of all U.S. hospitals have both an ED and PICU to evaluate and manage critically ill children (35,36). Thus, it is imperative that EDs without 24/7 access to pediatric subspecialists identify solutions to improve pretransfer care of this extremely vulnerable population.…”

Section: Discussionmentioning

confidence: 99%

Impact of Telemedicine on Severity of Illness and Outcomes Among Children Transferred From Referring Emergency Departments to a Children’s Hospital PICU*

Dayal

Hojman

Kissee

et al. 2016

Pediatric Critical Care Medicine

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Objectives: To compare the severity of illness and outcomes among children admitted to a children’s hospital PICU from referring emergency departments with and without access to a pediatric critical care telemedicine program. Design: Retrospective cohort study. Setting: Tertiary academic children’s hospital PICU. Patients: Pediatric patients admitted directly to the PICU from referring emergency departments between 2010 and 2014. Interventions: None. Measurements: Demographic factors, severity of illness, and clinical outcomes among children receiving care in emergency departments with and without access to pediatric telemedicine, as well as a subcohort of children admitted from emergency departments before and after the implementation of telemedicine. Main Results: Five hundred eighty-two patients from 15 emergency departments with telemedicine and 524 patients from 60 emergency departments without telemedicine were transferred and admitted to the PICU. Children admitted from emergency departments using telemedicine were younger (5.6 vs 6.9 yr; p< 0.001) and less sick (Pediatric Risk of Mortality III score, 3.2 vs 4.0; p < 0.05) at admission to the PICU compared with children admitted from emergency departments without telemedicine. Among transfers from emergency departments that established telemedicine programs during the study period, children arrived significantly less sick (mean Pediatric Risk of Mortality III scores, 1.2 units lower; p = 0.03) after the implementation of telemedicine (n = 43) than before the implementation of telemedicine (n = 95). The observed-to-expected mortality ratios of posttelemedicine, pretelemedicine, and no-telemedicine cohorts were 0.81 (95% CI, 0.53–1.09), 1.07 (95% CI, 0.53–1.60), and 1.02 (95% CI, 0.71–1.33), respectively. Conclusions: The implementation of a telemedicine program designed to assist in the care of seriously ill children receiving care in referring emergency departments was associated with lower illness severity at admission to the PICU. This study contributes to the body of evidence that pediatric critical care telemedicine programs assist referring emergency departments in the care of critically ill children and could result in improved clinical outcomes.

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“…The PEM subspecialty workforce, on the other hand, tends to be clustered in children's hospitals and urban centers. While PEM subspecialists tend to the minority of pediatric emergency visits, they provide expertise and guidance through communication and outreach, are a referral resource for children needing escalating levels of care, and are a conduit by which children in general emergency centers may access pediatric specialty care . In addition, PEM subspecialists in academic centers are responsible for a large proportion of pediatric knowledge generation and research.…”

Section: Methodsmentioning

confidence: 99%

2018 Academic Emergency Medicine Consensus Conference: A Workforce Development Research Agenda for Pediatric Care in the Emergency Department

Merritt

Dietrich

Bogie

et al. 2018

Academic Emergency Medicine

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Each year, more than 30 million children visit U.S. emergency departments (EDs). Although the number of pediatric emergency medicine specialists continues to rise, the vast majority of children are cared for in general EDs outside of children's hospitals. The diverse workforce of care providers for children must possess the knowledge, experience, skills, and systemic support necessary to deliver excellent pediatric emergency care. There is a crucial need to understand the factors that drive the professional development and support systems of this diverse workforce. Through the iterative process culminating with the 2018 Academic Emergency Medicine consensus conference, we have identified five key research themes and prioritized a specific research agenda. These themes represent critical gaps in our understanding of the development and maintenance of the pediatric emergency care workforce and allow for a prioritization of future research efforts. Only by more fully understanding the gaps in workforce needs, and the necessary steps to address these gaps, can outcomes be optimized for children in need of emergency care. BACKGROUNDO ver four decades, emergency medicine (EM) has evolved from a fledgling specialty to a pillar for acute care for patients of all ages. The evolution of pediatric emergency medicine (PEM) has mirrored the evolution of EM itself, with subspecialization possible following either pediatrics or EM residency training. However, with just over 2,000 board-

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Pediatric Readiness and Facility Verification

Cited by 95 publications

References 18 publications

Pediatric Readiness in Critical Access Hospital Emergency Departments

Pediatric Readiness in Critical Access Hospital Emergency Departments

Impact of Telemedicine on Severity of Illness and Outcomes Among Children Transferred From Referring Emergency Departments to a Children’s Hospital PICU*

2018 Academic Emergency Medicine Consensus Conference: A Workforce Development Research Agenda for Pediatric Care in the Emergency Department

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