Consensus-driven model to establish paediatric emergency care measures for low-volume emergency departments

• Published in: BMJ open quality 2022-07, Vol.11 (3), p.e001803
• Main Authors: Remick, Katherine E, Bartley, Krystle A, Gonzales, Louis, MacRae, Kate S, Edgerton, Elizabeth A
• Format: Article
• Language: English
• Subjects: Clinical medicine; Collaboration; Continuity of care; Delphi method; Emergency department; Emergency medical care; Emergency services; Families & family life; Healthcare quality improvement; Medicine; Paediatrics; Patient safety; Patient-centered care; Pediatrics; Quality improvement; Quality measurement; Research & Reporting Methodology; Usability
• ISSN: 2399-6641; 2399-6641
• DOI: 10.1136/bmjoq-2021-001803

The National Paediatric Readiness Project applies a systems approach (care coordination, QI, policies and procedures, staff competencies, patient safety and equipment and supplies) to ensuring high-quality emergency care for children among diverse EDs.2 Paediatric readiness, as determined by the National Paediatric Readiness Assessment using a weighted 100-point scale, is associated with decreased paediatric mortality among critically ill and injured children.2 4–10 Facilities that incorporate paediatric-specific QI initiatives demonstrate a 26-point increase in their paediatric readiness score.11 Engagement in paediatric readiness efforts is high, yet integration of paediatric QI efforts in EDs is lagging.2 While over 400 paediatric emergency care performance measures have been proposed and prioritised, widespread uptake has been limited.2 12–14 Infrequent paediatric patient encounters make it difficult to assess the cause and effect of care processes. Consensus panel The panel consisted of 41 members who were either identified by their respective national professional society as a content expert or were selected based on the following criteria: expertise in paediatric emergency care applied research, emergency medical services for children, QI, QI data registries, specific areas of clinical practice, clinical practice setting, healthcare system networks, regulatory agencies and federal partners (table 1, online supplemental appendix A).Table 1 Characteristics of consensus panel Characteristic Participants, % (N) N=41 Pediatric Emergency Care Applied Research (EA, EK*, CM, RS, SD*, TC*) 14.6 (6) Emergency Medical Services for Children (CM, CN, EL, HH, MGH) 12.2 (5) Quality Experts from National Professional Societies 26.8 (11)  American Academy of Family Physicians (DF)    American Academy of Pediatrics (RP, SJ)    American College of Emergency Physicians (IB, JA, KG)    American College of Surgeons Committee on Trauma (AJ)    Emergency Nurses Association (RK, SS)    National Association of State Emergency Medical Services Officials (AV)    Pediatric Trauma Society (LG)   Quality Improvement Data Registries (BM) 2.4 (1) Health System Networks 4.9 (2)  US Acute Care Solutions (SI)    Hospital Corporation of America (HCA) Healthcare (AY)   Regulatory body 2.4 (1)  The Joint Commission (TE)   Federal partners 4.9 (2)  Health Resources and Services Administration (LL)    National Highway and Traffic Safety Administration, Office of Emergency Medical Services