The National Pediatric Readiness Project (NPRP) Clinical Quality Measures were developed through a modified Delphi process with input from 25+ professional organizations and pediatric emergency care experts. Together, these 28 evidence-based measures are designed to improve the quality and consistency of pediatric emergency care and ultimately improve outcomes for children.

These measures take a holistic approach, addressing all aspects of an ED triage and medical history, diagnostic tests, treatment interventions, and patient transitions (discharge, admission, or transfer). They serve as the national framework for measuring and improving pediatric emergency care, with NPRQI providing participating EDs with the tools, benchmarking and reporting needed to collect data and drive improvement.

To learn how the measures were developed, read our publication on the measure development process. For a deeper look at the selection of the NPRP Clinical Quality Measures, including the rationale behind each focus area for the NPRQI Collaborative and supporting references, click here to view the full explanation and reference document.


Focused on seven common pediatric conditions, EDs can track any number of these measures to ensure comprehensive care.

NPRP Clinical Quality Measures

Clinical Area of Focus Phase of Care Directionality Measure Description

Patient Assessment and Reassessment

Assessment

Increase

Percentage of pediatric patients with weight documented in kilograms only

Assessment

Increase

Percentage of pediatric patients with pain assessed

Assessment

Increase

Percentage of pediatric patients with vital signs reassessed

Intervention

Decrease

Median time from collection of first set of vital signs to first intervention (e.g., oxygen, medication)

Disposition

Decrease

ED length of stay (ED arrival to discharge)

Interfacility Transfer

Disposition

Increase

Percentage of transferred pediatric patients who met the site-specific criteria for transfers

Disposition

Decrease

Time from arrival to transport.

Disposition

Decrease

Percentage of transferred pediatric patients that were discharged from the receiving center within <24 hours of arrival.

Blunt Head Trauma

Assessment

Increase

Percentage of pediatric patients with a full set of vital signs obtained

Assessment

Increase

Percentage of pediatric patients with a Glasgow Coma Scale reassessment

Diagnostics

Increase

Percentage of pediatric patients with a head CT that met evidence-based criteria

Intervention

Decrease

Percentage of pediatric patients who received inappropriate hypotonic fluids

Seizures

Assessment

Increase

Percentage of pediatric patients with a neurologic reassessment

Intervention

Increase

Percentage of pediatric patients who received at least one additional class of antiepileptics (for patients requiring >2 doses of benzodiazepines)

Diagnostics

Decrease

a.) Percentage of pediatric patients who underwent invasive diagnostic assessments: blood glucose, blood work, lumbar puncture

b.) Percentage of pediatric patients who underwent head CT

Respiratory

Intervention

Increase

Percentage of pediatric patients with asthma or croup that received a steroid

Intervention

Decrease

Median time to steroids in patients diagnosed with asthma or croup (ED arrival to steroid administration)

Intervention

Increase

Percentage of pediatric patients >2 years with a diagnosis of asthma that received a beta agonist

Intervention

Decrease

Median time to beta agonist administration in patients >2 with a diagnosis of asthma (ED arrival to beta agonist administration)

Intervention

Decrease

Percentage of pediatric patients who received an antibiotic

Diagnostics

Decrease

Percentage of pediatric patients who underwent unnecessary chest radiography

Vomiting and Dehydration

Intervention

Increase

Percentage of pediatric patients who receive an antiemetic

Intervention

Decrease

Time to first antiemetic (ED arrival to emetic administration)

Intervention

Increase

Percentage of pediatric patients who received oral rehydration

Mental Health

Assessment

Increase

Percentage of pediatric patients who had a structured suicide screen

Assessment

Increase

Percentage of pediatric patients with a positive suicide screen who had a structured suicide assessment

Intervention

Increase

Percentage of pediatric patients with a positive suicide screen who had a consultation with a licensed mental health professional

Intervention

Increase

Percentage of pediatric patients with a positive suicide screen who received a discharge safety plan


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