The power of an idea: A conversation with Dr. Marianne Gausche-Hill

It has been four decades since the Emergency Medical Services for Children (EMSC) Program began its critical, lifesaving work to improve emergency care for children. Since the program’s initial authorization by Congress in 1984, EMSC has supported research and partnerships that don’t just study ways to make pediatric emergency care better, but put that data into practice to ensure the nation’s 5,000 emergency departments (EDs) and 15,000 emergency medical services (EMS) agencies are Pediatric-Ready.

With its recent five-year reauthorization in December 2024, Congress gave the EMSC Program the legal authority to continue to collect, analyze and apply data, including performance measures; create resources and tools; and establish practices like the adoption of pediatric emergency care coordinators, who promote and coordinate pediatric improvement efforts.

Today, the EMSC Program is an expansive national network that includes multiple research components, quality improvement tools and resources, and state partnerships. But it began with a vision held by James Seidel, MD, PhD, and Calvin Sia, MD that was passed on to the physicians they trained.

One of those young doctors was Marianne Gausche-Hill, MD, FACEP, FAAP, FAEMS. In the early 1980s, Gausche-Hill was a medical student, and Seidel was one of her mentors. While she is now co-director of EMSC’s National Pediatric Readiness Project (NPRP), it was while working with Seidel as a medical student that pediatric emergency care became her vocation. “There was really nothing for children then,” recalls Gausche-Hill. “There weren’t even objectives in the training for EMS providers.”

After graduating from medical school, Gausche-Hill’s path led to a fellowship with Seidel, where she managed one of EMSC’s earliest Targeted Issues Grants awarded to California to find new approaches to improving emergency care for children. From there, she went on to become the first fellowship-trained emergency physician to be boarded in pediatric emergency medicine.

“EMS for Children was trying to get a foothold at that time,” she said, noting that it was necessary for pediatric emergency care specialists to build trust within the EMS community, and with organizations like the American Academy of Pediatrics. “Trauma centers were just coming on board, there was really no research. In fact, the EMS for Children Program became the largest funder of EMS research at the time.”

One of Gausche-Hill’s earliest projects was a detailed assessment of the readiness of California’s EDs to care for kids according to the 2001 AAP/American College of Emergency Physician guidelines. The EMSC Program tapped her to expand that assessment nationally. The ED-focused National Pediatric Readiness Project was born, followed by the EMS-focused Prehospital Pediatric Readiness Project. Gausche-Hill’s medical fellow for these projects was Kate Remick, MD, FAAP, FACEP, FAEMS, now co-director of the NPRP, ushering in the next generation of pediatric emergency physicians—and EMSC leaders.

For more than 40 years, medical professionals, many family members, and partners of EMSC have spent countless hours collecting, analyzing, and applying data to create and share practical tools and resources. Best of all, this impressive network of resources and expertise has been demonstrated to help EDs and EMS agencies save lives. A study published in JAMA in January 2023 showed that children with injuries and medical conditions treated in EDs well-prepared to care for pediatric patients experienced a 60% to 76% reduction in short-term mortality and a 41% to 66% reduction in long-term mortality.

To learn more about the EMSC Program, visit https://emscimprovement.center.