Factors Associated With Improved Pediatric Resuscitative Care in General Emergency Departments-Reference-Cited by-同舟云学术

Factors Associated With Improved Pediatric Resuscitative Care in General Emergency Departments

Published:2023-07-07 Issue:2 Volume:152 Page:
ISSN:0031-4005
Container-title:Pediatrics
language:en
Short-container-title:

Author:

Auerbach Marc A.¹,Whitfill Travis¹,Montgomery Erin²,Leung James³,Kessler David⁴,Gross Isabel T.¹,Walsh Barbara M.⁵,Fiedor Hamilton Melinda⁶,Gawel Marcie¹,Kant Shruti⁷,Janofsky Stephen⁶,Brown Linda L.⁸,Walls Theresa A.⁹,Alletag Michelle¹⁰,Sessa Anna¹¹,Arteaga Grace M.¹²,Keilman Ashley¹³,Van Ittersum Wendy¹⁴,Rutman Maia S.¹¹,Zaveri Pavan¹⁵,Good Grace⁹,Schoen Jessica C.¹⁶,Lavoie Meghan⁹,Mannenbach Mark¹²,Bigham Ladonna¹⁷,Dudas Robert A.¹⁷,Rutledge Chrystal¹⁸,Okada Pamela J.¹⁹,Moegling Michelle²⁰,Anderson Ingrid²⁰,Tay Khoon-Yen⁹,Scherzer Daniel J.²¹,Vora Samreen²²,Gaither Stacy¹⁸,Fenster Daniel²³,Jones Derick¹⁶,Aebersold Michelle²⁴,Chatfield Jenny²⁵,Knight Lynda²⁶,Berg Marc²⁶,Makharashvili Ana¹,Katznelson Jessica¹⁷,Mathias Emily²⁷,Lutfi Riad²,Abu-Sultaneh Samer²,Burns Brian¹³,Padlipsky Patricia²⁸,Lee Jumie²⁹,Butler Lucas³⁰,Alander Sarah³¹,Thomas Anita¹³,Bhatnagar Ambika¹,Jafri Farrukh N.³²,Crellin Jason³¹,Abulebda Kamal²

Affiliation:

1. aYale University School of Medicine, New Haven, Connecticut

2. bIndiana University School of Medicine, Indianapolis, Indiana

3. cMcMaster University, Hamilton, Ontario, Canada

4. dColumbia University Vagelos College of Physicians and Surgeons, New York, New York

5. eBoston University School of Medicine, Boston, Massachusetts

6. fUPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania

7. gUniversity of California San Francisco, San Francisco, California

8. hThe Warren Alpert Medical School of Brown University, Providence, Rhode Island

9. iPerelman School of Medicine at the University of Pennsylvania and Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

10. jUniversity of Colorado Anschutz Medical Campus, Aurora, Colorado

11. kGeisel School of Medicine at Dartmouth, Hanover, New Hampshire

12. lMayo Clinic College of Medicine and Science, Rochester, Minnesota

13. mUniversity of Washington and Seattle Children’s Hospital, Seattle, Washington

14. nAkron Children’s Hospital, Akron, Ohio

15. oThe George Washington University School of Medicine and Health Sciences, Washington, District of Columbia

16. pMayo Clinic Health System, Albert Lea and Austin, Minnesota

17. qJohns Hopkins School of Medicine, Baltimore, Maryland

18. rThe University of Alabama at Birmingham, Birmingham, Alabama

19. sUniversity of Texas, Southwestern Medical Center, Dallas, Texas

20. tCase Western Reserve University and UH Rainbow Babies and Children’s Hospital, Cleveland, Ohio

21. uNationwide Children’s Hospital, Columbus, Ohio

22. vChildren’s Minnesota, Minneapolis, Minnesota

23. wColumbia University Irving Medical Center, New York, New York

24. xSchool of Nursing

25. yAlberta Children’s Hospital, Calgary, Alberta, Canada

26. zStanford Medicine Children’s Health, Palo Alto, California

27. aaUniversity of Michigan, Ann Arbor, Michigan

28. bbHarbor UCLA Medical Center, Torrance, California

29. ccThe Lundquist Institute, Torrance, California

30. ddVirginia Mason Medical Center, Seattle, Washington

31. eeGeisinger Commonwealth School of Medicine, Scranton, Pennsylvania

32. ffWhite Plains Hospital Center, White Plains, New York

Abstract

OBJECTIVES To describe the quality of pediatric resuscitative care in general emergency departments (GEDs) and to determine hospital-level factors associated with higher quality. METHODS Prospective observational study of resuscitative care provided to 3 in situ simulated patients (infant seizure, infant sepsis, and child cardiac arrest) by interprofessional GED teams. A composite quality score (CQS) was measured and the association of this score with modifiable and nonmodifiable hospital-level factors was explored. RESULTS A median CQS of 62.8 of 100 (interquartile range 50.5–71.1) was noted for 287 resuscitation teams from 175 emergency departments. In the unadjusted analyses, a higher score was associated with the modifiable factor of an affiliation with a pediatric academic medical center (PAMC) and the nonmodifiable factors of higher pediatric volume and location in the Northeast and Midwest. In the adjusted analyses, a higher CQS was associated with modifiable factors of an affiliation with a PAMC and the designation of both a nurse and physician pediatric emergency care coordinator, and nonmodifiable factors of higher pediatric volume and location in the Northeast and Midwest. A weak correlation was noted between quality and pediatric readiness scores. CONCLUSIONS A low quality of pediatric resuscitative care, measured using simulation, was noted across a cohort of GEDs. Hospital factors associated with higher quality included: an affiliation with a PAMC, designation of a pediatric emergency care coordinator, higher pediatric volume, and geographic location. A weak correlation was noted between quality and pediatric readiness scores.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics, Perinatology and Child Health

Link

https://publications.aap.org/pediatrics/article-pdf/doi/10.1542/peds.2022-060790/1566946/peds_2022060790.pdf

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