Pediatric Emergency  Care Coordinators

In June 2016, Indiana EMS for Children (iEMSC) published their first Pediatric Emergency Care Coordinator (PECC) Newsletter to support improvements in pediatric readiness across Indiana's Hospitals. Specifically, this newsletter is intended to support those serving as Pediatric Emergency Care Coordinators in their departments (whether by formal title or scope of work practiced) as well as to provide information for all of those interested in improving care for children in their EDs. Nationwide research demonstrates EDs that have a physician or nurse in this designated in this role is better prepared to care for children presenting to the Emergency Department.  Elizabeth Weinstein, MD, Principal Investigator for the iEMSC grant program agrees the network of PECC is a community of information sharing.  "The ability to share ideas and challenges across the state focusing on quality improvement, patient safety, and continuing education moves us towards better preparedness to care for Indiana's children," she said. 

The PECC network allows for improvement in care capabilities across the state and will provide essential resources for individuals serving in this role or interested in learning more. You can define your involvement.  This newsletter will serve as a forum for sharing.   Here is a link to a brief survey that will allow you to indicate your desired level of participation in this community, as well as provide feedback on this newsletter and topics or items you would like to see featured in future publications.
Pediatric Readiness Assessment Portal Reopens
 
In 2013-2014 Indiana Hospitals participated in a National Pediatric Readiness Assessment which benchmarked each facility's readiness to treat and manage the pediatric population in the emergency setting.  This project has entered the second phase, which is to provide each hospital the opportunity to update and/or correct data.  It is also each facility's opportunity to demonstrate growth in treatment of the pediatric patient as we strive to not only meet, but exceed national standards. 
 
All hospitals with an emergency department that is open 24/7 may complete the assessment. To complete the assessment, please work with your Nurse Manager or ED Director, go to  www.pedsready.org , select your state, county, and hospital's name.  It is recommended that you print a paper version of the assessment prior to submitting electronically as the survey cannot be reopened to make changes.  It is estimated to take on average 26 minutes to complete the online assessment once you have compiled your data.
 
After completing the assessment, each respondent will receive an immediate Pediatric Readiness Score and a Gap Analysis based on the Joint Policy Statement: Guidelines for the Care of Children in the Emergency Department (published in Pediatric, October 2009 and Annals of Emergency Medicine October 2009).  This online report will provide further analysis on key areas of strength and weakness with the assessment. Facilities will also receive benchmark data, comparing their Emergency Department's readiness against facilities with similar pediatric volume.  
 
Each facility responses are important to develop meaningful needed benchmarks and growth indicators and to provide the best possible data for the development of local and regional gap analyses and targets resources. Responses will be kept confidential and will be combined with responses from other hospitals for reporting purposes only.
 
All facilities interested will need to complete the survey by December 1, 2016.

Quality Improvement Process in Emergency Department 
The American Academy of Pediatrics (AAP), American College of Emergency Physicians (ACEP), and Emergency Nurses Association (ENA) 2009 joint policy statement "Guidelines for Care of Children in the Emergency Department," provides important direction and benchmarks for readiness to care for children in your Emergency Department.
 
Ensuring that your ED has the appropriate equipment to care for children is a smart place to start.   Equipment should be well maintained, clearly labeled and stored in easy to access areas.  Physicians, advanced practice providers, nurses and techs should be familiar with where the equipment is stocked and how it is organized. 
 
Some examples of problems and problem solving around equipment:
 
1)    Problem:  "We almost never use 3.0 ETT, 3.5 ETT and 4.0 ETT. We never seem to use pediatric LMAs.  These are expensive to stock and maintain."
Potential Solutions: You may be able to work with other departments (such as anesthesia, L&D or NICU) to perform stock rotation.  So that as your equipment is getting closer to expiration you can rotate with their newer stock and they can use the equipment before it expires.  Stock rotation can also be done within health systems, so that smaller hospitals can rotate stock with their associated larger institutions.
 
2)    Problem: "We see a small volume of children and haven't found an equipment organization process that works for us."
Potential Solutions: Some departments have found success purchasing organization systems such as Broselow systems or Handtevy, others have had success by maintaining separate Airway kits for pediatric patients. The most important thing is that your department identifies a system that is maintained and that is familiar to all providers.
 
Please send us examples of equipment problems you have faced in your department as well as solutions you have identified. Please tweet @IndianaEMSC, FB at Indiana Emsc, or via email to  margo.knefelkamp@indianapolisems.org.

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Contact Information:

Program Director:
Elizabeth Weinstein, M.D.

Program Manager:
Margo Knefelkamp

3930 Georgetown Rd., Indianapolis, IN 46254
margo.knefelkamp@indianapolisems.org
(317) 630-7742