Important new developments in pediatric readiness

Oct. 03, 2023

According to Denise B. Klinkner, M.D., M.Ed., a pediatric trauma surgeon and the medical director of Mayo Clinic's pediatric trauma center in Rochester, Minnesota, there are now some need-to-know changes in pediatric readiness for trauma centers. Here are her top two new developments and some action steps to make a difference at your facility:

Practice-changing data. A paper published in a September 2021 issue of JAMA Pediatrics demonstrated a strong association of hospital upper quartile pediatric readiness — a score of 93 or higher — and lower mortality than hospitals whose emergency departments (EDs) scored in the lowest quartile for pediatric readiness. Complications, however, remained unchanged regardless of score. The investigators' results did not change across strata, subgroups and multiple sensitivity analyses. Notably, the investigators found that 126 children who died in care at EDs in the lowest quartile of pediatric readiness would not have died in EDs with the highest quartile of pediatric readiness.

Requirement for ACS site visits. Previously, taking anonymous pediatric readiness surveys for your hospital and making relevant changes was entirely optional, though encouraged. Now, bolstering your hospital ED's pediatric readiness will be necessary for any American College of Surgeons (ACS) site visit for level 1, 2 or 3 trauma centers occurring in September 2023 or later. The ACS will require proof of taking the pediatric readiness survey, available at the National Pediatric Readiness Project site, and a plan to address any gaps in a pediatric readiness report. Based on the above study, the target goal is a score of 93.

Dr. Klinkner calls this paper and the need to address your hospital's pediatric readiness for ACS site visits as "a call to action pointing to a way we can improve survival of injured children."

She believes that key steps in this action include:

  • Make supply requests on behalf of pediatric patients. When requesting supplies, always put the needs of the patient first, and especially the supply needs of injured children.
  • Be creative in use of pediatric supplies with expiration dates. Dr. Klinkner suggests exchanging equipment with another, larger medical center so the close-to-expiration supplies can be used promptly.
  • Take the pediatric readiness survey and get your hospital's score. Dr. Klinkner says that knowledge is power. If you know what is missing, she indicates, it is much easier to address it.
  • Appoint a pediatric readiness champion at your center if there is not one yet. She cites that most centers see more success in moving the needle with pediatric readiness if they have a champion for the cause. The individual selected for this role in many centers is a nurse.

"Kids are important, and we can make a difference in their outcomes when they are injured," says Dr. Klinkner. "Data from the JAMA Pediatrics paper show that patient outcomes are improved by optimal pediatric readiness scores."

Often, reaching out for help with resources can make a big difference in becoming more peds ready, she says.

"Don't be overwhelmed that becoming pediatric ready will be expensive," says Dr. Klinkner. "There are lots of free resources, and you can check with your referring pediatric center for suggestions for lower cost improvements."

For more information

Newgard CD, et al. Evaluation of emergency department pediatric readiness and outcomes among US trauma centers. JAMA Pediatrics. 2021;175:947.

National Pediatric Readiness Project. Emergency Medical Services for Children Innovation and Improvement Center.

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