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

Autor: Abulebda K; Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine and Riley Hospital for Children at Indiana University Health, Indianapolis, IN. Electronic address: kabulebd@iu.edu., Whitfill T; Department of Pediatrics, Yale University School of Medicine, New Haven, CT; Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT., Montgomery EE; LifeLine Critical Care Transport, Indiana University Health, Indianapolis, IN., Thomas A; Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine, Seattle, WA., Dudas RA; Department of Pediatrics, Johns Hopkins All Children's Hospital, Saint Petersburg, FL., Leung JS; Division of Pediatric Emergency Medicine, Department of Pediatrics, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada., Scherzer DJ; Division of Pediatric Emergency Medicine, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, OH., Aebersold M; University of Michigan, School of Nursing, Ann Arbor, MI., Van Ittersum WL; Division of Pediatric Hospital Medicine, Department of Pediatrics, Akron Children's Hospital, Northeast Ohio Medical University, Akron, OH., Kant S; Department of Emergency Medicine and Pediatrics, University of California San Francisco, San Francisco, CA., Walls TA; Department of Pediatrics, Division of Emergency Medicine, The Children's Hospital of Philadelphia at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Sessa AK; Office of Emergency Medical Services, Dartmouth-Hitchcock Medical Center, Lebanon, NH., Janofsky S; Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh, Pittsburgh, PA., Fenster DB; Department of Emergency Medicine, Morgan Stanley Children's Hospital of New York Presbyterian at Columbia University Medical Center, New York, NY., Kessler DO; Department of Emergency Medicine, Morgan Stanley Children's Hospital of New York Presbyterian at Columbia University Medical Center, New York, NY., Chatfield J; KidSIM-ASPIRE Simulation Research Program, Alberta Children's Hospital, University of Calgary, Calgary, Alberta, Canada., Okada P; Department of Pediatrics, University of Texas Southwestern School of Medicine, Dallas, TX., Arteaga GM; Department of Pediatrics and Adolescent Medicine, Division of Pediatric Critical Care, Mayo Clinic, Rochester, MN., Berg MD; Davison of Critical Care Medicine, Lucile Packard children's Hospital Stanford, Stanford University College of Medicine, Palo Alto, CA., Knight LJ; Davison of Critical Care Medicine, Lucile Packard children's Hospital Stanford, Stanford University College of Medicine, Palo Alto, CA., Keilman A; Department of Pediatrics, Division of Emergency Medicine, University of Washington School of Medicine, Seattle, WA., Makharashvili A; Department of Pediatrics, Yale University School of Medicine, New Haven, CT., Good G; Department of Pediatrics, Division of Emergency Medicine, The Children's Hospital of Philadelphia at the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA., Bingham L; Department of Pediatrics, Johns Hopkins All Children's Hospital, Saint Petersburg, FL., Mathias EJ; Department of Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI., Nagy K; Division of Pediatric Hospital Medicine, Department of Pediatrics, Akron Children's Hospital, Northeast Ohio Medical University, Akron, OH., Hamilton MF; Department of Critical Care Medicine and Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, PA., Vora S; Children's Minnesota, Minneapolis, MN., Mathias K; Children's Minnesota, Minneapolis, MN., Auerbach MA; Department of Pediatrics, Yale University School of Medicine, New Haven, CT; Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT.
Jazyk: angličtina
Zdroj: The Journal of pediatrics [J Pediatr] 2021 Mar; Vol. 230, pp. 230-237.e1. Date of Electronic Publication: 2020 Oct 31.
DOI: 10.1016/j.jpeds.2020.10.040
Abstrakt: 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 benchmarking 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.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: