Adopting Pediatric Readiness Standards Improves Survival

Emergency departments (EDs) that have the highest levels of coordination of health care, personnel, procedures and medical equipment needed to care for ill and injured children have far higher rates of survival than hospitals with low readiness, according to an NIH-funded study. 

Researchers found that more than 1,400 children’s deaths may have been prevented if hospital EDs had adopted national pediatric care readiness standards as laid out by the National Pediatric Readiness Project. The six-year study of 983 emergency departments in 11 states followed nearly 800,000 children.

According to the project’s checklist, readiness standards include specifications for physician and nurse certification, patient assessment, triage, medication administration and trauma resuscitation and stabilization.

In the current study, researchers sought to determine whether adopting the readiness standards would lower the death rate among children admitted to EDs for serious injury or illness. They ranked the EDs into quartiles based on the extent they had implemented the readiness standards.

Compared to children cared for in low-readiness departments, children with injuries cared for in high-readiness departments had a 60% lower chance of dying in the hospital; and children with medical illness had a 76% lower chance of dying while they were in the hospital. Similarly, among roughly 545,000 children in six states, injured children in the highest quartile had a 41% lower chance of dying within a year and children with medical issues had a 66% lower chance of dying within a year, compared to children cared for in hospitals in the lowest readiness quartile.

The study, funded by NICHD and the Health Resources and Services Administration (HRSA), appears in JAMA Network Open.