TI Grants Focusing on PECCs

CONNECTICUT – Yale University. Pediatric Emergency Care Coordination in EMS Agencies: Measuring the Influence, Magnifying the Improvement (Principal Investigator: Mark X. Cicero, MD).

Pediatric Emergency Care Coordinators (PECCs) are believed to have a positive effect on pediatric prehospital care by ensuring training, education, and resources that establish standards and encourage guideline adherence in EMS agencies. However, many aspects of PECC training and evaluation, as well as the effects of PECCs on health outcomes and EMS agencies, remain unstudied. This project’s goal is to assess the impact of PECC designation on the quality of clinical care, on patient and family-centered outcomes, and to determine the best methods for establishing PECCs among EMS agencies. The project is being conducted in three states: Connecticut, Rhode Island and Colorado. The project objectives include: (1) an assessment of PECCs’ effect on EMS pediatric care and health outcomes; (2) establishing the best methods for assigning PECCs and for execution of their role in EMS agencies; and (3) characterizing the activities and outcomes of an effective PECC and development of an evaluation process to measure effectiveness of a PECC on EMS agencies. Health outcomes to be assessed include ED and hospital lengths of stay, adherence to EMS protocols including medication administration, ED disposition, and response to therapy.

LOUISIANA – Louisiana Department of Health, Office of Public Health. Pediatric Care Coordination in EMS Agencies – Improving Child Health Outcomes in Louisiana (Principal Investigators: Toni Gross, MD, MPH and Gail Gibson, RN, MSN, FABC).

This project will improve system readiness in Louisiana’s emergency healthcare system by creating a statewide consortium of PECCs in EMS agencies. Establishing this statewide system of collaboration will provide resources, support networks, education, training, and personnel development that will ultimately improve pediatric emergency care across Louisiana. Data from multiple EMS agencies collectively serving over 35,000 pediatric patients annually will be linked to hospital ED data to determine how the presence of PECCs in the pre-hospital setting affects pediatric patient health outcomes. The objectives are to: (1) develop a statewide system of PECCs that will provide education, training, and resources regarding pediatric emergency care and equipment to EMS agencies; (2) establish and maintain partnerships that work toward improved prehospital pediatric emergency care provided by EMS agencies; (3) increase prehospital pediatric guideline adherence in order to decrease medication errors and improve initiation of appropriate treatment in a prehospital setting; and (4) collect and share data from EMS agencies regarding the results and effectiveness of the PECC program and communicate findings to EMSC stakeholders. Health outcomes to be assessed include mortality, discharge from hospital into a skilled nursing or rehabilitation facility, hospital length of stay, and return of spontaneous circulation in out-of-hospital cardiac arrest.

NORTH CAROLINA – University of North Carolina at Chapel Hill. System Readiness Improvements through the EMS Pediatric Emergency Care Coordinators Program (Principal Investigator: Jane Brice, MD, MPH).

Due to high personnel turnover and inexperience in pediatric emergency care among EMS workers, it can be difficult to ensure that new medical guidelines are fully implemented in a timely manner. The goal of this project is to expand upon and improve an existing program and establish a sustainable, affordable, and replicable program comprised of prehospital PECCs supported by a rich system of resources and accountability tools. The objectives are to: (1) standardize the role and position description of a PECC and implement PECCs in specified rural areas of North Carolina; (2) institute an online PECC Hub that will provide educational resources and training for both PECCs and EMS providers, including access to Performance Adherence Reports (PARs); (3) broaden the current PAR program by implementing PARs and educational courses which include additional nationally-recommended prehospital performance measures; and (4) use a mixed methods design to evaluate successful facets of the PECC program, as well as any limitations or adverse outcomes. The focus is on assessing impact on several areas of prehospital care, including but not limited to seizure, altered mental status, cardiac arrest, health care equipment and special needs, and behavioral health.