Improving Pediatric Readiness in General Emergency Departments: A Prospective Interventional Study

Objective To describe the impact of a national interventional collaborative on pediatric readiness within general emergency departments (EDs). Study design A prospective, multicenter, interventional study measured pediatric readiness in general EDs before and after participation in a pediatric readiness improvement intervention. Pediatric readiness was assessed using the weighted pediatric readiness score (WPRS) on a 100-point scale. The study protocol extended over 6 months and involved 3 phases: (1) a baseline on-site assessment of pediatric readiness and simulated quality of care; (2) pediatric readiness interventions; and (3) a follow-up on-site assessment of WPRS. The intervention phase included a bench-marking performance report, resources toolkits, and ongoing interactions between general EDs and academic medical centers. Results Thirty-six general EDs were enrolled, and 34 (94%) completed the study. Four EDs (11%) were located in Canada, and the rest were in the US. The mean improvement in WPRS was 16.3 (P < .001) from a baseline of 62.4 (SEM = 2.2) to 78.7 (SEM = 2.1), with significant improvement in the domains of administration/coordination of care; policies, protocol, and procedures; and quality improvement. Six EDs (17%) were fully adherent to the protocol timeline. Conclusions Implementing a collaborative intervention model including simulation and quality improvement initiatives is associated with improvement in WPRS when disseminated to a diverse group of general EDs partnering with their regional pediatric academic medical centers. This work provides evidence that innovative collaboration facilitated by academic medical centers can serve as an effective strategy to improve pediatric readiness and processes of care.

Automated summary

This study demonstrates that a national interventional collaborative can significantly improve pediatric readiness within general emergency departments by implementing simulation and quality improvement initiatives in partnership with academic medical centers. The mean improvement in weighted pediatric readiness score (WPRS) was 16.3, with significant enhancements in administration/coordination of care, policies, protocol, and procedures, and quality improvement. This collaborative intervention model led to improved pediatric readiness and care processes.