title: Pediatric Readiness in Indian Health Service and Tribal Emergency Departments: Results from the National Pediatric Readiness Project.
abstract: BACKGROUND
  In 2014, 45 Indian Health Service (IHS)/Tribal emergency departments serving American Indian and Alaskan Native communities treated approximately 650,000 patients of which, 185,000 (28%) were children and youth younger than 19 years. This study presents the results of the National Pediatric Readiness Project (NPRP) assessment of the 45 IHS/Tribal emergency departments.
  
  
  METHODS
  Data were obtained from the 2013 NPRP national assessment, which is a 55-question Web-based questionnaire based on previously published 2009 national consensus guidelines. The main measure of readiness is the weighted pediatric readiness score (WPRS), with the highest score being 100.
  
  
  RESULTS
  The overall mean WPRS for all emergency departments is 60.9. Of the IHS/Tribal emergency departments that had pediatric emergency care coordinators, scores across all domains were higher than those of emergency departments without pediatric emergency care coordinators. All 45 emergency departments have readily available a pediatric medication dosing chart, length-based tape, medical software, or other system to ensure proper sizing of resuscitation equipment and proper dosing of medication. Of the 45 IHS/Tribal 37% report having 100% of the equipment items, and 78% report having at least 80% of these items.
  
  
  CONCLUSIONS
  This article reports the results of the NPRP assessment in IHS/Tribal emergency departments that, despite serving a historically vulnerable population, scored favorably when compared with national data. The survey identified areas for improvement, including implementation of QI processes, stocking of pediatric specific equipment, implementation of policies and procedures on interfacility transport, and maintaining staff pediatric competencies.
authors.affiliation: Rockville, MD, Philadelphia, PA, Salt Lake City, UT, and Torrance, CA. Electronic address: Julie.sadovich@gmail.com.
authors.forename: Juliana
authors.initials: J
authors.lastname: Sadovich
authors.affiliation: Rockville, MD, Philadelphia, PA, Salt Lake City, UT, and Torrance, CA.
authors.forename: Terry
authors.initials: T
authors.lastname: Adirim
authors.affiliation: Rockville, MD, Philadelphia, PA, Salt Lake City, UT, and Torrance, CA.
authors.forename: Russell
authors.initials: R
authors.lastname: Telford
authors.affiliation: Rockville, MD, Philadelphia, PA, Salt Lake City, UT, and Torrance, CA.
authors.forename: Lenora M
authors.initials: LM
authors.lastname: Olson
authors.affiliation: Rockville, MD, Philadelphia, PA, Salt Lake City, UT, and Torrance, CA.
authors.forename: Marianne
authors.initials: M
authors.lastname: Gausche-Hill
authors.affiliation: Rockville, MD, Philadelphia, PA, Salt Lake City, UT, and Torrance, CA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Edgerton
mesh_terms: D000293:Adolescent; D002648:Child; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006801:Humans; D010372:Pediatrics / Q000379:methods* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States; D016549:United States Indian Health Service / Q000706:statistics & numerical data*
keywords: American Indian/Alaskan Native; Pediatric emergency care; Pediatric readiness; Quality improvement