Prehospital Domain Update!

The EIIC Prehospital Domain supports all prehospital care-related activities within EMSC. Currently, the primary focus of the Prehospital Domain is supporting the national Prehospital Pediatric Readiness Project (PPRP).

In anticipation of the publication of a joint policy statement on pediatric readiness in Emergency Medical Services Systems, the EIIC convened the PPRP Steering Committee, comprised of representatives from federal partners (HRSA/MCHB, NHTSA Office of EMS, Indian Health Services, ASPR Office of Emergency Management and Medical Operations), EMSC State Partnership Programs (Program Managers and FAN), and 20 national organizations. The purpose of the PPRP Steering Committee is to ensure emergency care for all children by improving the pediatric emergency care outcomes and patient safety at the local, regional, and state levels within the prehospital environment.

In July 2020, the Steering Committee approved an EMS Agency Pediatric Readiness Checklist, which is based on the Pediatric Readiness in Emergency Medical Services Systems Policy Statement. The purpose of the Checklist is to foster the self-assessment of EMS agency pediatric readiness. Earlier this year, the PPRP Steering Committee formed three work groups to accomplish different key processes to reach the Steering Committee’s goals, which can be found in the Charter. The objectives of these work groups include: creation of a Frequently Asked Questions document (to support EMS agency use of the Checklist), development of a toolkit for EMS agencies to use, and development of an EMS agency national assessment of prehospital pediatric readiness (based on the Checklist).

The steering committee recently met in October 2020 to collaborate and share the progress being made by each work group. The feedback on a recent pilot of the PPRP Checklist was presented and work is underway to finalize a Frequently Asked Questions document. It is anticipated that there will be a nationwide rollout in late 2020. The PPRP Toolkit content has been developed and will be made available in a user-centric platform housed on the EIIC webpage. The availability of the PPRP Toolkit will coincide with the launch of the PPRP Checklist and is projected to go live in 2021. The Steering Committee also reviewed draft questions for the national PPRP assessment of EMS Agencies. The official launch date of the national EMS assessment is yet to be determined.

To learn more about the PPRP Steering Committee and the work happening in the EIIC Prehospital Domain, please visit our page on the EIIC website here. For questions, email mailto:pprp@emscimprovement.center.

Pediatric Core Outcome Set After Cardiac Arrest (P-COSCA) Advisory Seeks to Improve Peds Resuscitation

In 2018, the International Liaison Committee on Resuscitation (ILCOR) sponsored the COSCA initiative (Core Outcome Set After Cardiac Arrest) to improve consistency in reported outcomes of clinical trials of adult cardiac arrest survivors and has since supported a new P-COSCA initiative (Pediatric COSCA). The P-COSCA includes assessment of survival, brain function, cognitive function, physical function, and basic daily life skills. Survival and brain function are assessed at discharge or 30 days (or both if possible) and between 6 and 12 months after arrest. Cognitive function, physical function, and basic daily life skills are assessed between 6 and 12 months after cardiac arrest. Because many children have prearrest comorbidities, the P-COSCA also includes documentation of baseline (i.e., prearrest) brain function and calculation of changes after cardiac arrest. Supplementary outcomes of survival, brain function, cognitive function, physical function, and basic daily life skills are assessed at 3 months and beyond 1 year after cardiac arrest if resources are available. To access P-COSCA (Pediatric Core Outcome Set for Cardiac Arrest) in Children: An Advisory Statement From the International Liaison Committee on Resuscitation, go here.

EIIC Strengthens Our Commitment to Social Justice, Equity and Equality

The mission of the Emergency Medical Service for Children Innovation and Improvement Center (EIIC) is to reduce child and youth morbity and mortality resulting from severe illness or injury in ALL children. We recognize that advocating for social justice, equity and equality is essential for improving quality and safety.

Each month, we will devote a section of this newsletter to this topic that will highlight diverse voices from our stakeholders and include resources from our partners and collaborating national organizations. This month’s segment has been submitted by Robin Suzor, Montana EMS for Children Program Manager.

Culture of Care Toolkit

The Montana EMSC developed a Cultural of Care Toolkit to provide resources and training to facilitate the development of cultural competence and humility in one’s self, colleagues, the work environment and its application to practice.

Cultural competence is the ability of health organizations and practitioners to recognize the cultural beliefs, values, attitudes, traditions, language preferences, and health practices of diverse populations and to apply the knowledge to produce a positive health outcome.

Cultural Competence is possessing knowledge-based understanding and skills with which to provide culturally acceptable and relevant care with diverse cultures. Cultural Humility is:

• A life-long process of self-reflection that includes being aware of one’s personal beliefs and biases,
• Understanding and recognizing the inherent power imbalances in patient provider communication, and
• Using patient focused care to demonstrate mutual respect and partnership with patients, families, and co-workers.

Cultural competence is grounded in a set of ethical principles that guide continual cultivation of self-awareness, respectful behaviors, and the pursuit of knowledge. The culturally competent health care professional should be a positive role model and provide training to others on cultural competency, as well as open to listening and learning from all. This action creates a collaborative, respectful work environment and a responsive culture of care.

An understanding of cultural diversity, health disparities, health literacy, and cultural competence is vital in providing the best possible interactions with those of which you serve.

This Culture of Care Toolkit provides information and activities that will help increase knowledge on:

• How population data presented by race and ethnicity has contributed to making health disparities a priority in our state and the nation.
• How cultural competence begins with the individual.
• How language and culture influence how we approach health and provide care.
• How Providers and patients/clients bring their unique cultural backgrounds and expectations to the medical encounter.
• How there must be effective communication between patients and providers for quality care to result.

This Culture of Care Toolkit is organized into specific training modules that can be utilized in one-hour segments or in any training time frame that fits the organizations’ specific needs. Each training component, along with a short activity, help to enhance knowledge of providing culturally appropriate care in a practice, service and or facility. A genuine understanding of cultural and patient centered care concepts is critical in treating unique patient populations. Learn more about the toolkit by following this link.

NEW!! NQF Rural Telehealth and Healthcare System Readiness Committee

The National Quality Forum (NQF) is convening a multi-stakeholder committee to create a measurement framework linking quality of care delivered by telehealth, healthcare system readiness, and health outcomes in a disaster. The new Rural Telehealth and Healthcare System Readiness Committee will build on the 2016-2017 Framework to Support Measure Development for Telehealth and the 2019 Healthcare System Readiness Measurement Framework. The Committee will focus on quality of care provided in rural areas and will discuss, update, and enhance the previously developed telehealth framework to ensure its relevance for person-centered measurement, patient safety, and value-based measurement and to ensure it addresses new as well as ongoing opportunities and challenges, in part due to the COVID-19 pandemic. For more info on the committee or to sign up for project updates, click this link.

HRSA’s National Survey of Children’s Health

Each year the Maternal and Child Health Bureau at the Health Resources and Services Administration (HRSA) collects information from parents and caregivers on the physical, emotional, and behavioral health of children ages 0-17 years old in the United States. The survey is meant to be a tool with reliable data for researchers and policymakers on a wide range of factors that can influence children’s health – from the prevalence and impact of special health care needs, to adverse childhood experiences and mental and behavioral health. HRSA also released a new brief on Rural/Urban Differences in Children’s Health using the combined data of the 2017-2018 surveys. Find more here.

Following a period of uncertainty marked by a global pandemic and a national moment of racial reckoning, we are facing potential transitions in leadership: from the White House, to Congress, to the Supreme Court, and to the states. Children, families and communities are counting on our nation's leaders to act and advance policies that keep them healthy and safe.

We can and must do more for children.

That is why the American Academy of Pediatrics (AAP) has updated its Blueprint for Children, which outlines a comprehensive child health policy agenda for 2020 and beyond.

This Blueprint for Children makes clear how much is at stake. It reflects on the State of Children in 2020 and recommends policies to promote healthy children, support secure families, build strong communities, and reclaim America’s role as a leading nation for youth.

History shows us that when we invest in children, we invest in our country's future. To read the Blueprint for Children, please visit AAP.org/Blueprint.