Alaska — SPROC

Alaska EMSC SPROC Program

June 1, 2012 - May 31, 2016

Grant Number

H3AMC24071

Project Overview

This SPROC Program investigated solutions to overcome challenges of promptly delivering specialized pediatric care to children in rural, frontier, and wilderness communities of the state including the indigenous Alaska Native and American Indians. This project focused on: (1) increasing statewide pediatric-specific disaster preparedness training; (2) integrating pediatric components into state disaster response planning; (3) establishing a pediatric regionalization of care program; and (4) integrating pediatric components into the current state trauma designation, consultative, and educational processes.

Institution

Department of Health and Social Services, Trauma Program

Main Contact

Julie Rabeau

Award Amount

$400,000

Contacts

Name	Role(s)	Phone	Email
Julie Rabeau	Principal Investigator

Disseminations

Title	Type	Publication/Event	Published/Presented	Identifier	Details
Evaluating Systems of Pediatric Care in Remote and Frontier Alaska - Defining Essential Next Steps for Improvement	Presentation	EMSC Webinar	2016 Not Recorded View Flyer		Evaluating Systems of Pediatric Care in Remote and Frontier Alaska - Defining Essential Next Steps for Improvement Author(s)/Presenter(s) Julie Rabeau & Matthew Hirschfeld Abstract/Description More than 31 million children and adolescents access the emergency care system every year. Unfortunately, pediatric resources to provide optimal care for children are not always readily available where children live, play, and attend school. This is especially true in Alaska. Alaska is two and a half times larger than Texas. The 2010 Census for the state estimated a total population of 71,023 with children, under the age of 18 years, accounting for 26.4% of this number. With 75% of Alaskan communities not connected by roads to a hospital, travel is often expensive necessitating creative alternatives to assure access to essential pediatric services when an emergency occurs. Julie Rabeau, RN, EMSC State Partnership Regionalization of Care (SPROC) grantee, and Matthew Hirschfeld MD, PhD, medical director, Maternal Child Health Services at Alaska Native Medical Center, will discuss challenges encountered in providing emergency care to children in frontier and remote areas of Alaska. A quality improvement initiative implemented through the SPROC grant focused on evaluating the continuum of care and identifying opportunities for improving the care of severely injured children will also be highlighted. Innovative approaches to improving aeromedical resource availability, as well as educational opportunities were shared.
Alaska Trauma System and Mass Casualty 2016 Events	Presentation	SE Alaska EMS Symposium	2016 Not Recorded
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