California — SPROC

Transport of Acutely Ill and Injured Children to Institutions of Higher Care from Allied Localities

June 1, 2012 - Dec. 7, 2020

Grant Number
Project Overview
2012-2016: partnering of the North Coast EMS Agency, the UC Davis Medical Center, the United Indian Health Services, and the North Coast Clinics Network to develop a regionalized, standardized health care delivery system for children; integrating evidence-based emergency medical services into the pediatric emergency care system either by transport and/or telemedicine; and increasing access to ongoing education and pediatric quality care to remote, rural, and under-served areas within the state through organized transfer processes and use of telemedicine.
2016-2021: Building upon the successes of a 2012 SPROC grant received by the University of California, TACTICAL. The 2012 project successfully developed a coordinated, regionalized, and culturally sensitive system of care for emergency medical services for children in a rural, underserved, three-county EMS agency, North Coast EMS (NCEMS), in northern California. The project facilitated quality improvement (QI) efforts, comprehensive pediatric coverage thru the use of telemedicine, and the participation and successful recognition of all NCEMS receiving hospital emergency departments (EDs) in a pediatric readiness recognition program known as Emergency Departments Approved for Pediatrics (EDAP). The project team plans to enhance pediatric capabilities by expanding TACTICAL into a second service region in California, the Sierra-Sacramento Valley (S-SVEMS). The targeted regions being addressed by TACTICAL serve rural and under-served communities inadequately prepared to provide high-quality care to seriously ill children. Project goals include: (1) Implement, improve, and sustain continuous pediatric-specific quality improvement in EDs located in rural and underserved communities in both NCEMS and S-SVEMS regions; (2) Improve the ability of EDs in the S-SVEMS region to care for acutely ill and injured children by increasing readiness to evaluate and treat pediatric patients via expansion of telemedicine and EDAP; and (3) Provide pediatric education and training in the management of acutely ill and injured children to prehospital and hospital providers, as well as a monitoring process for care that includes the establishment of a data collection system in the NCEMS and S-SVEMS regions.
Regents of the University of California
Award Amount


Name Role(s) Phone Email
James Marcin, MD, MPH
  • Project Director
(916) 734-4726
Ilana Sigal, MPH
  • Program Manager
(916) 734-2639


Title Format Description Published/Revised Availability
Family Centered Care Packet Toolkit Essential documents and supplies for families having children transferred to another facility – i.e. directions to new facility, where to … 2015 Not Available


Title Type Publication/Event Published/Presented Identifier Details
Association between emergency department pediatric readiness and transfer of noninjured children in small rural hospitals Research Paper/Publication Journal of Rural Health 2021
California SPROC Program TACTICAL Project Update Presentation 2019 EMSC All Grantee Meeting 2019
Emergency Medical Services Utilization by Children Research Paper/Publication Pediatric Emergency Care 2019
Urban and rural patterns in emergent pediatric transfer: a call for regionalization Research Paper/Publication Journal of Rural Health 2014