Pediatric Readiness Reaches New Ground Amidst Capacity Crisis

Pediatric readiness – the EMSC-driven effort to ensure every EMS agency and emergency department (ED) is ready to provide the specialized emergency care children require – is making headlines and reaching an international audience this month. The progress comes amidst a national shortage of pediatric beds as the result of a 15% decline in the number of hospitals with pediatric wards coupled with a surge in pediatric cases due respiratory illnesses. According to the U.S. Department of Health and Human Services, as of Oct. 21, more than 74% of the country’s pediatric inpatient beds are occupied. Several states and territories, including D.C., Maine, and Rhode Island, are at more than 120% capacity. Cases are expected to continue to rise as the result of a so-called “tripledemic” of influenza, enterovirus/rhinovirus and COVID-19.

Is your hospital experiencing a surge? Access resources.

In the headlines 

The inpatient bed shortage was covered in an Oct. 11 New York Times article, “As Hospitals Close Children’s Units, Where Does That Leave Lachlan?” The article featured Kate Remick, MD, FAAP, Co-Director of the EMSC Innovation and Improvement Center, who spoke about pediatric readiness and the importance of being prepared to care for children in crises and every day. 

That story led to additional coverage, including a PBS NewsHour segment. While the segment focused primarily on inpatient care, it closed by highlighting a statistic from a 2018 EMSC paper on pediatric readiness.

“The surge crisis is a reminder that we, as a health care system, have to do more to prioritize children’s needs,” says Remick. 

Codifying pediatric readiness

Weaving pediatric readiness into the fabric of everyday emergency care is an ongoing effort across the EMSC Program in collaboration with the American Academy of Pediatrics (AAP), the American College of Emergency Physicians (ACEP), and the Emergency Nurses Association (ENA). 

The four organizations are official partners in the National Pediatric Readiness Project, one of the EMSC Program’s twin initiatives to assess and advance pediatric readiness at the ED and EMS agency levels.

On Oct. 3, the AAP, ACEP, and ENA published their first joint policy statement on the topic of pediatric patient safety in the ED setting. The policy statement and its accompanying technical report emphasize pediatric readiness; patient safety is one of the seven domains or focus areas outlined by pediatric readiness guidelines.

“The statement is a great opportunity to truly help move the needle in optimizing the quality of care that children receive, regardless of which ED they visit,” says Mohsen Saidinejad, MD, MS, MBA, senior author of the publication and a member of the EMSC Innovation and Improvement Center executive team.

International reach

At the same time as pediatric readiness made waves nationally, it also reached new audiences at the international level. During the week of Oct. 24, the EMSC Program hosted five health care leaders from Denmark to discuss pediatric readiness efforts in both countries. 

The group took part in a daylong virtual forum as well as site visits conducted through the Massachusetts, Rhode Island, and Connecticut EMSC State Partnership Programs. Hospitals visited included:

• Boston Children’s Hospital – Boston, MA
• UMass Memorial - Worcester, MA
• Hasbro Children’s - Providence, RI
• Westerly Hospital - Westerly, RI
• L+M Hospital - New London, CT
• Middlesex Hospital – Middletown, CT
• Bridgeport Hospital – Bridgeport, CT
• Milford Hospital – Milford, CT
• Yale-New Haven Hospital – New Haven, CT

“Thank you to everyone for taking the time to share your knowledge with us during this very busy period for all your EDs,” said Lasse Høgh Andersen, MD, one of the participants and a senior consultant pediatric anesthesiologist and critical care specialist at Glostrup Hospital in Denmark. “Everything we have learned from this visit will be of great value in our future work with establishing a Danish national pediatric readiness project.”

In addition, a new study about pediatric readiness efforts in a Canadian province, “Evaluation of baseline pediatric readiness of emergency departments in Manitoba, Canada,” was published online Oct. 10 in the International Journal of Emergency Medicine. One of the authors is Terry Klassen, MD, MSc, FRCPC, Director of Translating Emergency Knowledge for Kids (TREKK), which partners with the EIIC on its Pediatric Education and Advocacy Kits.

New data on the horizon

The spotlight on pediatric readiness grows just as the National Pediatric Readiness Project prepares to publish results of its 2021 national assessment of 3,647 EDs. To be notified when results are published, sign up here.

Photo caption: Bottom photo: One of the delegation’s many hospital visits was to Middlesex Hospital in Middletown, CT.