Pediatric Emergency Care Coordinators and Quality of Care

If you have any questions or would like more information, please contact Dr. Margaret Samuels-Kalow at msamuels-kalow@partners.org.

Investigators:
Margaret E. Samuels-Kalow, MD, MPhil, MSHP (Principal Investigator)
Carlos A. Camargo, Jr, MD, DrPH (Co-Investigator)
Rebecca E. Cash, PhD, MPH (Co-Investigator)
Elizabeth R. Alpern, MD, MSCE (Co-Investigator)
Kenneth A. Michelson, MD, MPH (Co-Investigator)
Krislyn M. Boggs, MPH (Project Coordinator

Funding Source:
National Institutes of Health (R01 HD103637)

Aims:

  • Aim 1: Identify PECC implementation factors that are associated with variation in quality of emergency care for children.
  • Aim 2: Establish if PECC status is associated with higher quality of care for children treated in general.
  • Aim 3: Determine if disparities in quality of care by race/ethnicity and insurance vary by PECC status.

Rationale:
Over 90% of pediatric emergency department (ED) visits occur in general EDs rather than specialty pediatric EDs. However, general EDs face significant challenges to providing high quality care, including that over half of EDs care for fewer than 10 children per day. Policy efforts to improve care in general EDs have primarily focused on pediatric readiness. Having a pediatric emergency care coordinator (PECC; a staff member responsible for pediatric readiness) is strongly associated with higher readiness, but only 15-20% of general EDs have a PECC. Because many of the factors associated with pediatric readiness are immutable (e.g. geography, patient volume), it is critically important to understand how modifiable factors, such as a PECC, affect outcomes.

Design and Setting:
We will conduct a mixed-methods study including a cross-sectional study of pediatric emergency visits and in-depth qualitative interviews with selected EDs.

Study Populations:

  • EDs in Arkansas, Florida, Iowa, Maryland, Nebraska, New York, Vermont, and Wisconsin
  • General ED visits during 2019 for children under 18
  • Key ED stakeholders (e.g., nursing directors, PECCs)

Data Sources:
This project will involve the linkage of multiple data sources:

In addition, EMNet will collect data via in-depth qualitative interviews with nursing directors.