New Mexico — SPROC

A Child Ready System of Regionalized Pediatric Emergency Care

June 1, 2012 - May 31, 2021

Grant Number

H3AMC24075

Project Overview

2012-2016: Focusing on children and families in tribal and rural areas of New Mexico, the project team planned: (1) establish a partnership between the University of New Mexico (UNM) Division of Pediatric Emergency Medicine and the UNM Center for Native American Health to develop and disseminate a Child Ready system of regionalized pediatric emergency care in New Mexico and the border regions of Arizona, Colorado, Texas, and Mexico; (2) provide assistance to facilities in achieving a level of readiness to manage pediatric emergencies; (3) provide assistance to providers caring for acutely ill or injured children thru the use of telemedicine; and (4) conduct injury prevention activities in communities.
2016-2021: The New Mexico project team is also building upon lessons learned from a prior Child Ready SPROC award. The 2012 project utilized a community self-assessment approach to attempt to regionalize care where very limited resources exist. Using the community self-assessments, the project team designed, developed, and disseminated a Child Ready System of Regionalized Pediatric Emergency Care in New Mexico and the border regions of Arizona, Colorado, Texas, and Mexico. The team worked with communities to assess levels of preparedness to care for the acutely ill or injured child, regardless of where the emergency occurred – at school, in the park, in the prehospital rig, in the health center, or in the local ED. The New Mexico Child Ready Project now plans to continue its efforts to (1) Expand the Child Ready novel community self-assessment process; (2) Prepare facilities to manage pediatric emergencies; (3) Assist providers caring for acutely ill or injured children; (4) Conduct community injury prevention activities; and (5) Continue the development and expansion of the Child Ready Virtual Pediatric Emergency Department Telehealth Network (CR-VPedED) as a mechanism to support regionalization of resources.

Institution

University of New Mexico School of Medicine Department of Emergency Medicine

Main Contact

Robert Sapien, MD, MMM

Award Amount

$1,100,000

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Contacts

Name	Role(s)	Phone	Email
Norman Cooeyate	Cultural Liason	(505) 925-4439	ncooeyate@salud.unm.edu
Robert Sapien, MD, MMM	Principal Investigator	(505) 272-6349	rsapien@salud.unm.edu
Katherine Schafer, BS	Program Manager

Products

Title	Format	Description	Published/Revised	Availability
Child Ready Web Talk: Neonatal Emergencies Parts 1 and 2; Household Poisonings and Child Maltreatment	Podcast		2016	Not Available

Disseminations

Title	Type	Publication/Event	Published/Presented	Identifier	Details
Urban and rural patterns in emergent pediatric transfer: a call for regionalization	Research Paper/Publication	Journal of Rural Health	2014	PMID: 24164349 DOI: 10.1111/jrh.12051	Urban and rural patterns in emergent pediatric transfer: a call for regionalization Author(s)/Presenter(s) Timothy Horeczko, James Marvin, Jeremy Kahn, Robert Sapien Abstract/Description Context: National groups call for the regionalization of health care, to direct patients with high-risk conditions to designated hospitals with greater capabilities. Currently there is limited information detailing the characteristics and specific needs of acutely ill and injured children who require transfer to another institution, especially in underserved rural communities. Purpose: To determine the epidemiology of pediatric transfers from urban and rural emergency departments (EDs). Methods: We analyzed data in the National Hospital Ambulatory Medical Care Survey from 1995 to 2010. Eligible children were <18 years of age seen in a United States ED, and transferred to another hospital after initial evaluation. Findings: Of all 283,232,058 pediatric ED visits, less than 0.5% resulted in a transfer, yielding a population-based estimate of 900,100 transfers nationally during this period. Urban and rural EDs showed similar transfer rates. Children transferred from rural EDs were older and more likely to arrive by emergency medical services than children transferred from urban EDs (12.1 vs 8.2 years of age, P < .01). Children from rural EDs were more than twice as likely to be transferred for a psychiatric indication (43.5% vs 19.5%, P < .01). Conclusions: Emergency pediatric transfers are uncommon in the United States; transfer rates are similar in urban and rural settings. Rural children have additional obstacles to care, especially in access to emergency mental health services. Programs to study and implement regionalization of care should consider diverse patient populations and target improvement in coordination of care, transfer times, and outcomes. Keywords access to care; health disparities; mental health; policy; utilization of health services View On Pub Med