title: Assessing Structural Quality Elements of Pediatric Emergency Care.
abstract: 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.
authors.affiliation: From the *The Children's Mercy Hospital, Kansas City, MO; †Ann and Robert H. Lurie Children's Hospital of Chicago Northwestern University Feinberg School of Medicine, Chicago, IL; ‡Children's Hospital of Omaha, Omaha, NE; §Children's of Alabama, Birmingham, AL; ¶Children's Hospital Association, Alexandria, VA; and ∥#Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
authors.forename: Lisa L
authors.initials: LL
authors.lastname: Schroeder
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Alpern
authors.forename: Shuntel M
authors.initials: SM
authors.lastname: Blecher
authors.forename: Patty A
authors.initials: PA
authors.lastname: Peska
authors.forename: Marjorie L
authors.initials: ML
authors.lastname: White
authors.forename: Julie A
authors.initials: JA
authors.lastname: Shaw
authors.forename: Carla
authors.initials: C
authors.lastname: Hronek
authors.forename: Cary W
authors.initials: CW
authors.lastname: Thurm
authors.forename: Evaline A
authors.initials: EA
authors.lastname: Alessandrini
mesh_terms: D002648:Child; D002662:Child Health Services / Q000600:supply & distribution*; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000592:standards* / Q000600:supply & distribution; D004636:Emergency Service, Hospital / Q000592:standards*; D004638:Emergency Treatment; D004865:Equipment and Supplies, Hospital / Q000600:supply & distribution*; D019538:Health Care Surveys; D006776:Hospitals, Pediatric; D006801:Humans; D010372:Pediatrics / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*