Survey to help assess pediatric emergency readiness of hospital EDs

Marianne Gausche-Hill, M.D., and Kate Remick, M.D. - lead investigators at the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed) - are spearheading a statewide, web-based survey scheduled to roll out Jan. 6, 2012 that will help assess the pediatric emergency readiness of hospital emergency departments (EDs). As the first statewide survey of its kind, this project also represents an enormous quality improvement initiative that will help hospital EDs optimize the emergency care they provide to children of all ages, from neonates to adolescents. Following the roll-out in California, Drs. Gausche-Hill and Remick hope to coordinate the participation of hospitals nationwide.

Pediatric patients make up approximately 20 percent of all ED visits. There are roughly 400 hospitals in the state of California, with approximately 330 that have EDs. Based on previous studies, it is estimated that few EDs have all of the recommended pediatric equipment as specified in nationally published guidelines. In addition to assessing the current pediatric readiness of EDs, the survey is also designed to determine what resources hospitals are lacking, and how they can acquire the resources necessary to treat young patients, including equipment, medications, personnel, and patient safety issues.

"We are pleased that this project is finally coming to light as we know that many hospitals are challenged when caring for the littlest patients," said Dr. Gausche-Hill. "As we've seen with the recent earthquakes in Japan, Haiti and Turkey, there is very little time to act and react during a natural disaster, and so it is imperative that hospital EDs are day-to-day ready and prepared to treat the youngest victims of disaster."

The impetus for this project came about in 2006, when the Institute of Medicine (IOM) released a report "Emergency Care for Children: Growing Pains" regarding the challenges in the provision of emergency care for children. Based on this report, in 2009 national guidelines were developed by the American Academy of Pediatrics, the American College of Emergency Physicians, and the Emergency Nurses Association and supported by 22 other national and professional organizations - "Guidelines for the Care of Children in the Emergency Department" - that outlined the tools and resources necessary to care for children of all ages, including medical supplies, health care personnel, administrative coordinators, patient safety initiatives, pediatric protocols, and quality improvement processes.

The current survey will assess pediatric readiness in the following areas:

• Administration/Coordination of Emergency Department
• Personnel in Emergency Department (i.e. physicians, nurses, health care providers)
• Quality Improvement and Process Improvement in the Emergency Department
• Pediatric Patient Safety
• Development of Policies, Procedures and Protocols (i.e. how to deal with the death of a child, mental health issues, etc.)
• Support Services (i.e. laboratory and radiology capabilities)
• Equipment, Supplies and Medication