A note on comparability

The 2021 pediatric readiness national median score and 2013 pediatric readiness national median score are not directly comparable to measure progress (such as a baseline). Assessments are based on joint policy statements, which evolve as evidence and the health care landscape evolves. The 2013 assessment was based on the 2009 joint policy statement, “Guidelines for Care of Children in the ED.” The 2021 assessment was based on the 2018 joint policy statement, “Pediatric Readiness in the Emergency Department.”

While some questions were unchanged between assessment periods, others were added or modified. Therefore, comparability across assessment periods is not 1:1 except where individual questions remain the same. We recommend avoiding direct overall comparisons and/or framing scores within the context of their respective guidelines and assessments.

If you have any questions related to NPRP assessment scoring or guidelines, please email PedsReady@hsc.utah.edu.

When comparing common data elements between 2013 and 2021, the 2021 results demonstrated improvement in five of the six domains.

The five domains with improvement are:

1. Equipment and supplies
2. Patient safety
3. Personnel training and competencies
4. Policies and procedures
5. Quality improvement plan

Examples of notable improvements in these domains include:

• The number of EDs reporting weighing and recording in kilograms only, which is crucial for avoiding medication errors, rose from 67.7% to 74.5%.
• The number of EDs with a pediatric mental health care policy in place rose from 44.1% to 73.1%.
• The number of EDs with pediatric quality improvement (QI) plans in place rose from 45.1% to 50.0%.

However, there was a decline in a single but important assessment domain: administration and coordination.

The administration and coordination of pediatric components of emergency care involves the designation of a nurse and/or physician (ideally both), known as a pediatric emergency care coordinator (PECC). EDs reporting the presence of both a physician and nurse PECC decreased from 42% in 2013 to 28.5% in 2021.

The decrease in this domain is attributed to the loss of workforce during the COVID-19 pandemic, which exacerbated existing workforce shortages. The impact of the pandemic on the PECC role highlights the need to better define, formalize, and sustain the role as well as provide protected time for related responsibilities.

Largely due to the decrease in the heavily weighted administration and coordination domain, when comparing only these common data elements, the adjusted median score decreased slightly from 72.1 in 2013 to 70.5 in 2021.