How Ready is Your Agency to Provide Pediatric Care?

Children remain a small percentage of the patients most EMS clinicians see; 81% of agencies receive fewer than eight pediatric calls a month. Yet these are among the most stressful encounters clinicians experience, says Kathleen Adelgais, MD, MPH/MSPH, professor of pediatrics-emergency medicine at the University of Colorado School of Medicine and co-lead of the National Prehospital Pediatric Readiness Project (PPRP) in the Health Resources and Services Administration's EMS for Children (EMSC) program. “They remember every kid they saw…They worry if they did the right thing, because it’s not something that they commonly manage, to see a child who is listless, weak or not breathing well and then to be struggling to find the right equipment, to know what the right medication is or the right protocol.”

This, in a nutshell, is why EMSC launched a robust assessment of prehospital pediatric readiness nationwide. “The Readiness Project has really been designed to empower EMS and fire-rescue agencies to optimize their overall readiness,” continues Dr. Adelgais. The assessment—which takes about 30 to 45 minutes to complete—helps agencies understand what it means to be pediatric-ready. The goal is to have every ground 911 responding agency in the country, including fire-rescue and non-transporting agencies, complete the assessment by July 31, 2024.

After completing the questionnaire , an agency will immediately receive a confidential score indicating how pediatric-ready they are. The agency can consider this score in the context of the national average and an average score for agencies of similar size and with a similar volume of pediatric patients to benchmark their current performance. “This is a chance to better understand your ability to provide high-quality care for children,” Adelgais explains.

The project has developed a wide range of resources to help agencies take the next step in areas where there are gaps; a toolkit offers guidance for patient and medication safety, equipment and supplies, education, policies and procedures, and patient- and family-centered care, among other topics. You can also download a two-page checklist to quickly see specific competencies that make up a peds-ready EMS or fire-rescue agency.

In April 2024, Gam Wijutenge, director of NHTSA’s Office of EMS, moderated the webinar, “How Ready Is Your Agency to Provide Pediatric Care? Build Your Clinicians’ Confidence When Treating Children.” He was joined by Dr. Adelgais, Eric Hicken, EMS for Children and Special Projects Program Manager for the New Jersey Department of Health, and Chief Frank St. Denis, EMS Division Chief, Lenoir County Emergency Services in North Carolina.

Hicken calls the feedback he’s received from agencies who’ve completed the assessment “remarkable.” “They’re happy with the gap report they received and the information they got back from it,” he says. “They’ve told me that they’re going to use it to improve their procedures and policies.” One of the most impactful changes an agency can make, he says, is adding a pediatric emergency care coordinator, or PECC, to their team. “Agencies that had a PECC scored remarkably higher… It’s not that hard to implement a PECC and get that person in place. And there’s no real cost to it because it could be a shared role.”

Chief St. Denis, a PPRP Assessment field test participant, has found value in his agency’s results as well. “One of the nice things about the assessment is that they throw you back the national average, so you get to see how you align with the rest of the nation. We were a little bit shy of the national average, which I was kind of expecting. We are a rural agency; our resources are a bit limited. There are some things we have to do.”

“But,” he continues, “at the same time, some of the feedback given through the assessment were very simple, easy fixes that we’re able to do—maybe a training implementation we could do. One of the big things I learned was when [the survey asked about] our relationships with hospitals and providers; it was really easy to say, ‘okay, we need to have more sit-downs, more conversations and build better, stronger relationships with some of our facilities.”

To learn more or complete the survey, which is available in English and Spanish, go to emspedsready.org by July 31, 2024. You can also watch the April 2024 OEMS webinar and use the National PPRP toolkit of resources and checklist to learn more about becoming pediatric-ready at your agency.