Pediatric emergency care: How ready are hospital emergency departments to treat children?

Background: Nationally, 25% of emergency department (ED) visits are for patients 18 and under, and 90% of those visits are to non-children's hospitals. Results from a 2003 published survey showed substantial variation in ED compliance with national guidelines for the emergency treatment of children. The median readiness score calculated from weighted survey responses was 55 based on a 100-point scale. Methods: From January through July 2013, ED Nurse Managers nationwide are being surveyed to determine compliance with updated national guidelines in areas including equipment, coordination of care, and patient safety. Nurse Managers receive up to five personalized contacts to encourage survey completion. Upon completion, respondents immediately receive their ED's pediatric readiness score and suggested resources in areas needing improvement. EDs are grouped by pediatric patient volume for analysis. Results: As of February 1, nurses from 627 hospitals representing 4 million annual pediatric ED visits had responded. The median readiness score was 69, and had improved across all ED volumes since 2003. Overall, EDs scored highest in the areas of equipment and patient safety, and lowest in the areas of coordination of care and quality improvement. High volume EDs consistently showed higher readiness scores than low volume EDs. Conclusions: These results show an improvement in ED readiness to treat children over the last decade. However, continued effort is needed to encourage all EDs to improve readiness to treat children for everyday emergencies as well as in disaster situations. Final analysis from potentially 3,000 hospitals will be completed in August 2013.