From PECC networks to data dashboards: A look at recent TI grants
- Published December 2, 2024
As EMSC sunsets Targeted Issues (TI) Grants, we had a chance to learn about the work that is being completed at a recent EMSC Town Hall. In the TI grant cycle (2019-2024), EMSC invested in five projects that demonstrated the link between ED and EMS system readiness improvements and improved pediatric clinical care and health outcomes. Two projects focused on improving ED Pediatric Readiness and assessing how adoption of the Pediatric Readiness national guidelines is associated with changes in pediatric clinical care and health outcomes. Three projects worked to assess the impact of the presence of a pediatric emergency care coordinator (PECC) within an EMS agency.
ED projects
Project title: National Pediatric Readiness Quality Initiative (NPRQI)
Principal Investigator: Kate Remick, MD, The University of Texas Dell Medical School
Summary: NPRQI addresses critical barriers in EDs, including low pediatric patient volumes and limited access to actionable data, which make it difficult for EDs to engage in quality improvement (QI). By offering a free QI dashboard and visualization tool, NPRQI helps EDs measure, analyze, and enhance pediatric care capabilities. More than 100 EDs are currently enrolled nationwide.
Key takeaways:
- NPRQI is a valuable tool for all EDs to engage in QI work as part of Pediatric Readiness.
- NPRQI can support EDs in meeting state recognition program requirements.
- NPRQI is free, easy to use, and self-paced, and users have expressed significant satisfaction and benefit.
Project title: A Multi-State Evaluation of Emergency Department Pediatric Readiness Principal investigator: Craig Newgard, MD, MPH, Oregon Health & Science University
Summary: This project involved a Pediatric Readiness study group focused on evaluating variability in emergency and trauma care for children. The group published ten papers, which evaluated this variability, its impact on mortality, and associated costs through various lenses.
Key takeaways:
- High ED Pediatric Readiness saves lives.
- The costs of Pediatric Readiness are modest and reaching high ED readiness is highly cost-effective.
- New state-by-state and national estimates of costs and lives through Pediatric Readiness saved can help support uptake and buy-in in improvement efforts.
EMS projects
Project Title: Pediatric Emergency Care Coordination in EMS Agencies: Measuring the Influence, Magnifying the Improvement
Principal Investigator: Mark X. Cicero, MD, Yale University
Summary: This project evaluated the impact of PECCs on care quality and pediatric patient outcomes in the prehospital environment. Initiatives include developing simulations and family toolkits to assess care satisfaction, as well as analyzing resuscitation performance for children in critical conditions.
Key takeaways:
- A panel of EMS and family stakeholders successfully developed an instrument to assess family satisfaction with pediatric care, available here as part of the Prehospital Pediatric Readiness Project.
- In high acuity simulation, teams of EMS clinicians demonstrate better resuscitation performance for children with respiratory failure than for children with asystole or status epilepticus.
- Comparison of PECC to non-PECC agency encounters is undergoing analysis, with research publication planned.
Project Title: Pediatric Care Coordination in EMS Agencies – Improving Child Health Outcomes in Louisiana
Principal Investigators: Toni Gross, MD, MPH and Amanda Perry, MEd, NRP, Louisiana Department of Health, Office of Public Health
Summary: This project sought to measure the impact of PECCs on health outcomes. The team developed and coordinated a state network of PECCs, which met monthly virtually and in-person semi-annually. As part of its efforts, the project worked with a medication dosing software to train 30+ instructors and distribute the application to agencies who agreed to adopt the National Association of EMS Officials National Model EMS Clinical Guidelines. To map the impact of PECCs on outcomes, the team has collected in-depth data for several EDs and agencies, ranging from demographics to hospital admission.
Key takeaways:
- The group developed resources and learning opportunities for PECCs, including a PECC role description guide.
- In working with clinical partners and PECCs, it’s vital to ensure clear expectations and to understand they have many competing priorities, including workforce shortages, public health crises, etc.
- The project has collected a wide range of data and analysis is ongoing, with research articles planned.
Project Title: System Readiness Improvements through the EMS Pediatric Emergency Care Coordinators Program
Principal Investigator: Jane Brice, MD, MPH, University of North Carolina at Chapel Hill
Summary: This initiative sought to improve prehospital Pediatric Readiness in North Carolina with a focus on low-resource, low-volume areas. Their approach included education and performance adherence strategies through a program called “PECC+.” The program identified and trained PECCs for 12 total agencies, 10 that were rural and 2 that were suburban. As part of its work, the team also aimed to identify what PECC implementation strategies are most effective for EMS agencies.
Key takeaways:
- Some of the challenges PECCs faced include mixed ability to make independent decisions, limited protected time, and limited formal recognition of the role.
- To support agencies, the program developed 19 online courses, 15 pediatric performance adherence reports, an alert system, and other resources, many of which are available at https://pecc.med.unc.edu/.
- The team is continuing to analyze data and results for future publication.