Assessing Structural Quality Elements of Pediatric Emergency Care.
BACKGROUND AND OBJECTIVE: Emergency departments must have appropriate resources and equipment available to meet the unique needs of children. We assessed the availability of stakeholder-endorsed quality structure performance measures for pediatric emergency department patients.
METHODS: A survey of Child Health Corporation of America member hospitals was conducted. Six broad equipment groups were queried: general, monitoring, respiratory, vascular access, fracture-management, and specialized pediatric trays. Equipment availability was determined at the level of the individual item, 6 broad groups, and 44 equipment subgroups. The survey queried the availability of 8 protocol/procedure elements: method to identify age-based abnormal vital signs, patient-centered care advisory council, bronchiolitis evidence-based guideline, pediatric radiation dosing standards, suspected child abuse protocols, use of validated pediatric triage tool, and presence of nurse and physician pediatric coordinators.
RESULTS: Fifty-two percent (22/42) of sites completed the survey. Forty-one percent reported availability of all 113 recommended equipment items. Every hospital reported complete availability of equipment in 77% of the subgroups. The most common missing items were adult-sized lumbar puncture needles, hypothermia thermometers, and various sizes of laryngeal mask airways. Regarding the protocol/procedure elements, a method to identify age-based abnormal vital signs, pediatric radiation dosing standard, and nurse and physician pediatric coordinators were present in 100%. Ninety-five percent used a validated triage tool and had suspected child abuse protocols.
CONCLUSIONS: Presence of necessary pediatric emergency equipment is better in the surveyed hospitals than in prior reports. Most responding hospitals have important protocol/procedures in place. These data may provide benchmarks for optimal care.
Pediatric emergency care
Child; Child Health Services; Child, Preschool; Emergency Medical Services; Emergency Service, Hospital; Emergency Treatment; Equipment and Supplies, Hospital; Health Care Surveys; Hospitals, Pediatric; Humans; Pediatrics; Quality Assurance, Health Care
Children; ER; Children's Hospitals
Schroeder, Lisa L.; Alpern, Elizabeth R.; Blecher, Shuntel M.; Peska, Patty A.; White, Marjorie L.; Shaw, Julie A.; Hronek, Carla; Thurm, Cary W.; and Alessandrini, Evaline A., "Assessing Structural Quality Elements of Pediatric Emergency Care." (2016). Manuscripts, Articles, Book Chapters and Other Papers. 341.