Understanding Pediatric Readiness Focus Areas

What this focus area assesses: Leadership structure and accountability for pediatric emergency care, including designated Physician and Nurse Pediatric Emergency Care Coordinators (PECCs).

Why it matters: Clear pediatric leadership improves coordination, communication, and sustained focus on readiness activities across the department.

Planning tips:

• Confirm that PECC roles are formally designated and supported.
• Document responsibilities and time allocation, even in resource-limited settings.
• Use PECCs to champion education, policy review, and improvement efforts.

What this focus area assesses: Ongoing pediatric-specific competency evaluation and training for all staff who care for children.

Why it matters: Children present unique clinical, developmental, and safety needs that require targeted training across all roles.

Planning tips:

• Align pediatric competencies with existing education or credentialing processes.
• Include pediatric scenarios in simulations, drills, and team training.
• Ensure training spans all ages, from newborns through adolescents.

What this focus area assesses: Inclusion of pediatric-specific indicators within the ED’s quality or performance improvement (QI/PI) plan, with processes for data collection, analysis, system change, and ongoing monitoring.

Why it matters: Ongoing measurement and feedback help teams identify trends, implement system changes, and track progress over time.

Planning tips:

• Ensure pediatric-specific measures are explicitly included in the QI/PI plan.
• Define how pediatric data are collected, reviewed, and acted upon.
• Document system changes and monitor performance over time, not just one-time improvements.

What this focus area assesses: The presence of written policies, procedures, and protocols that address pediatric-specific clinical, operational, and family-centered care needs.

Why it matters: Clear, accessible policies support consistent care and help teams respond effectively in high-stress or infrequent pediatric scenarios.

Planning tips:

• Verify that pediatric-specific elements are addressed within ED policies, even if integrated into adult policies.
• Prioritize high-risk or high-frequency areas such as triage, abnormal vital sign notification, sedation, consent, and child maltreatment.
• Confirm policies address family presence, discharge planning, bereavement, and communication with the medical home.

What this focus area assesses: Preparedness planning for pediatric needs during disasters, mass casualty incidents, and public health emergencies.

Why it matters: Children require different equipment, medications, staffing considerations, and psychosocial supports during disasters, and families must be considered together.

Planning tips:

• Ensure the written disaster plan explicitly addresses pediatric needs across all core domains.
• Include pediatric surge capacity, decontamination, isolation, and reunification planning.
• Conduct pediatric-inclusive disaster drills, including a pediatric mass casualty incident, at least every two years.

What this focus area assesses: Availability of pediatric clinical pathways, order sets, or decision-support tools at the point of care.

Why it matters: Real-time access to evidence-based guidance improves consistency, safety, and outcomes.

Planning tips:

• Identify commonly used pediatric conditions and start there.
• Embed tools within the EHR or other clinical workflows.
• Ensure staff know where and how to access guidance.

What this focus area assesses: Written pediatric interfacility transfer agreements and guidelines that support timely, safe transfers to higher levels of care.

Why it matters: Clear transfer processes reduce delays, improve communication, and support safe, family-centered transitions.

Planning tips:

• Maintain written transfer agreements with receiving facilities.
• Define criteria for transfer, transport selection, and initiation of the transfer process.
• Ensure processes include transfer of patient information, family-centered care, and use of telehealth when available.

What this focus area assesses: Systems and practices that reduce medication, dosing, monitoring, and communication errors in children.

Why it matters: Children are at higher risk for safety events due to weight-based dosing, developmental differences, and communication barriers.

Planning tips:

• Standardize weighing and documentation in kilograms only.
• Use a consistent method for weight estimation when weighing is not possible.
• Ensure full pediatric vital signs are recorded and CO₂ monitoring is available.
• Maintain processes for safe medication prescribing, administration, and reporting of safety events, including 24/7 interpreter access.

What this focus area assesses: Coordination with imaging, laboratory, and other ED support services to meet pediatric-specific needs.

Why it matters: Pediatric readiness depends on aligned systems across the hospital, not just within the ED.

Planning tips:

• Confirm imaging protocols include age- or weight-appropriate dose reductions.
• Ensure processes are in place to transfer completed diagnostic images with pediatric patients.
• Engage radiology, laboratory, and other support services in pediatric readiness planning.

What this focus area assesses: Availability, organization, and maintenance of pediatric-appropriate medications, equipment, and supplies for children of all ages and sizes.

Why it matters: Immediate access to the correct tools is critical during pediatric emergencies, particularly in low-frequency, high-acuity situations.

Planning tips:

• Verify required pediatric medications, equipment, and supplies are available, clearly labeled, and logically organized.
• Educate staff on the location and use of pediatric equipment
• Maintain a daily process to check equipment location and functionality.
• Ensure length-based or weight-based tools are readily available to support accurate dosing and sizing.