Assessing Proximity Effect of High-acuity Pediatric Emergency Departments on the Pediatric Readiness Scores in Neighboring General Emergency Departments

Overview

Journal J Am Coll Emerg Physicians Open

Publisher Elsevier

Specialty Emergency Medicine

Date 2022 Nov 16

PMID 36381478

Authors

Kristina Brumme

Hilary A Hewes

Rachel Richards

Marianne Gausche-Hill

Katherine Remick

Joelle Donofrio-Odmann

Affiliations

Soon will be listed here.

Abstract

Study Objectives: The objective of this study was to determine if there is a proximity effect of high-acuity, pediatric-capable emergency departments (EDs) on the weighted pediatric readiness score of neighboring general EDs and whether this effect is attributable to specific components of the National Pediatric Readiness Guidelines.

Methods: Pediatric readiness was assessed using the weighted pediatric readiness score of EDs based on the 2013 National Pediatric Readiness Project assessment. High-acuity, pediatric-capable EDs were defined as those with a separate pediatric ED and inpatient pediatric services, including the following: pediatric ICU, pediatric ward, and neonatal ICU. Neighboring general EDs are within a 30-minute drive time of a high-acuity, pediatric-capable ED. Analysis was stratified by annual ED pediatric volume: low (<1800), medium (1800-4999), medium-high (5000-9999), and high (>10,000). We analyzed components of the readiness guidelines, including quality improvement/safety initiatives, pediatric emergency care coordinators, and availability of pediatric-specific equipment. Groups were compared using chi-squared or Wilcoxon rank-sum test with values <0.05 considered significant.

Results: Of the 4149 surveyed hospitals, 3933 general EDs (not high-acuity, pediatric-capable EDs) were identified, of which 1009 were located within a 30-minute drive to a high-acuity, pediatric-capable ED. Neighboring general EDs had a statistically significantly higher median weighted pediatric readiness score across pediatric volumes (weighted pediatric readiness score 76.3 vs 65.3; < 0.001). Neighboring general EDs were more likely to have a pediatric emergency care coordinator, a notification policy for abnormal pediatric vital signs, and >90% of pediatric-specific equipment.

Conclusions: We found neighboring general EDs have a higher level of pediatric readiness as measured by the median weighted pediatric readiness score. High-acuity, pediatric-capable EDs may influence the pediatric readiness of neighboring general Eds, but further investigation is needed to clarify target areas for outreach by state and national partners to improve overall pediatric readiness.

Citing Articles

Assessing proximity effect of high-acuity pediatric emergency departments on the pediatric readiness scores in neighboring general emergency departments.

Brumme K, Hewes H, Richards R, Gausche-Hill M, Remick K, Donofrio-Odmann J J Am Coll Emerg Physicians Open. 2022; 3(6):e12850.

PMID: 36381478 PMC: 9660843. DOI: 10.1002/emp2.12850.

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