Factors Associated With Improved Pediatric Resuscitative Care in General Emergency Departments
OBJECTIVES: To describe the quality of pediatric resuscitative care in general emergency departments (GEDs) and to determine hospital-level factors associated with higher quality. METHODS: Prospective observational study of resuscitative care provided to 3 in situ simulated patients (infant seizure, infant sepsis, and child cardiac arrest) by interprofessional GED teams. A composite quality score (CQS) was measured and the association of this score with modifiable and nonmodifiable hospital-level factors was explored. RESULTS: A median CQS of 62.8 of 100 (interquartile range 50.5-71.1) was noted for 287 resuscitation teams from 175 emergency departments. In the unadjusted analyses, a higher score was associated with the modifiable factor of an affiliation with a pediatric academic medical center (PAMC) and the nonmodifiable factors of higher pediatric volume and location in the Northeast and Midwest. In the adjusted analyses, a higher CQS was associated with modifiable factors of an affiliation with a PAMC and the designation of both a nurse and physician pediatric emergency care coordinator, and nonmodifiable factors of higher pediatric volume and location in the Northeast and Midwest. A weak correlation was noted between quality and pediatric readiness scores. CONCLUSIONS: A low quality of pediatric resuscitative care, measured using simulation, was noted across a cohort of GEDs. Hospital factors associated with higher quality included: an affiliation with a PAMC, designation of a pediatric emergency care coordinator, higher pediatric volume, and geographic location. A weak correlation was noted between quality and pediatric readiness scores.
Auerbach, Marc A.; Whitfill, Travis; Montgomery, Erin; Leung, James; Kessler, David; Gross, Isabel T.; Walsh, Barbara M.; Fiedor Hamilton, Melinda; Gawel, Marcie; Kant, Shruti; Janofsky, Stephen; Brown, Linda L.; Walls, Theresa A.; Alletag, Michelle; Sessa, Anna; Arteaga, Grace M.; Keilman, Ashley; Van Ittersum, Wendy; Rutman, Maia S.; Zaveri, Pavan; Good, Grace; Schoen, Jessica C.; Lavoie, Meghan; Mannenbach, Mark; Bigham, Ladonna; Dudas, Robert A.; Rutledge, Chrystal; Okada, Pamela J.; Moegling, Michelle; Anderson, Ingrid; Tay, Khoon-Yen; and Scherzer, Daniel J., "Factors Associated With Improved Pediatric Resuscitative Care in General Emergency Departments" (2023). GW Authored Works. Paper 3309.