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. STUDY DESIGN A prospective, multicenter, interventional study measured pediatric readiness in general emergency departments 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 six months and involved three 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 emergency departments and academic medical centers. RESULTS Thirty-six general emergency departments were enrolled, and 34 (94%) completed the study. Four EDs (11%) were located in Canada, and the rest were in the U.S. The mean improvement in WPRS was 16.3 (p<0.001) 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. CONCLUSION Implementing a collaborative intervention model including simulation and quality improvement initiatives is associated with improvement in weighted pediatric readiness scores (WPRS) when disseminated to a diverse group of general emergency departments 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.