title: Pediatric Readiness and Facility Verification.
abstract: OBJECTIVE
  We perform a needs assessment of pediatric readiness, using a novel scoring system in California emergency departments (EDs), and determine the effect of pediatric verification processes on pediatric readiness.
  
  
  METHODS
  ED nurse managers from all 335 acute care hospital EDs in California were sent a 60-question Web-based assessment. A weighted pediatric readiness score (WPRS), using a 100-point scale, and gap analysis were calculated for each participating ED.
  
  
  RESULTS
  Nurse managers from 90% (300/335) of EDs completed the Web-based assessment, including 51 pediatric verified EDs, 67 designated trauma centers, and 31 EDs assessed for pediatric capabilities. Most pediatric visits (87%) occurred in nonchildren's hospitals. The overall median WPRS was 69 (interquartile ratio [IQR] 57.7, 85.9). Pediatric verified EDs had a higher WPRS (89.6; IQR 84.1, 94.1) compared with nonverified EDs (65.5; IQR 55.5, 76.3) and EDs assessed for pediatric capabilities (70.7; IQR 57.4, 88.9). When verification status and ED volume were controlled for, trauma center designation was not predictive of an increase in the WPRS. Forty-three percent of EDs reported the presence of a quality improvement plan that included pediatric elements, and 53% reported a pediatric emergency care coordinator. When coordinator and quality improvement plan were controlled for, the presence of at least 1 pediatric emergency care coordinator was associated with a higher WPRS (85; IQR 75, 93.1) versus EDs without a coordinator (58; IQR 50.1, 66.9), and the presence of a quality improvement plan was associated with a higher WPRS (88; IQR 76.7, 95) compared with that of hospitals without a plan (62; IQR 51.2, 68.7). Of pediatric verified EDs, 92% had a quality improvement plan for pediatric emergency care and 96% had a pediatric emergency care coordinator.
  
  
  CONCLUSIONS
  We report on the first comprehensive statewide assessment of "pediatric readiness" in EDs according to the 2009 "Guidelines for Care of Children in the Emergency Department." The presence of a pediatric readiness verification process, pediatric emergency care coordinator, and quality improvement plan for pediatric emergency care was associated with higher levels of pediatric readiness.
authors: Austin-Travis County EMS System, Office of the Medical Director, and the Dell Children's Medical Center, Austin, TX. Electronic address: kate.remick@austintexas.gov.
authors: Katherine
authors: K
authors: Remick
authors: Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA; Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors: Amy H
authors: AH
authors: Kaji
authors: University of Utah Department of Pediatrics, National EMSC Data Analysis Resource Center, Salt Lake City, UT.
authors: Lenora
authors: L
authors: Olson
authors: University of Utah Department of Pediatrics, National EMSC Data Analysis Resource Center, Salt Lake City, UT.
authors: Michael
authors: M
authors: Ely
authors: University of Utah Department of Pediatrics, National EMSC Data Analysis Resource Center, Salt Lake City, UT.
authors: Patricia
authors: P
authors: Schmuhl
authors: Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA; Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA; UCLA School of Nursing, Los Angeles, CA.
authors: Nancy
authors: N
authors: McGrath
authors: EMSC and Injury Prevention, Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD.
authors: Elizabeth
authors: E
authors: Edgerton
authors: Department of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, CA; Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA; Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA; David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors: Marianne
authors: M
authors: Gausche-Hill
mesh_terms: D002140:California; D003695:Delivery of Health Care / Q000592:standards; D004636:Emergency Service, Hospital / Q000592:standards*; D006801:Humans; D020380:Needs Assessment; D016134:Organizational Policy; D010372:Pediatrics / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000592:standards*; D058996:Quality Improvement / Q000592:standards; D019984:Quality Indicators, Health Care / Q000592:standards*; D011795:Surveys and Questionnaires; D014481:United States