1. Pediatric Readiness Quality Collaborative
Introductory Webinar
10-July 2017

2. Acknowledgement
The HRSA, MCHB EIIC is supported in part by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U07MC This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.
Krystle

3. WHO WE ARE

4. TALKING POINTS Overview of EMS & EIIC
Overview of QI Collaborative Efforts
Introduce 1st National Pediatric Readiness Quality Collaborative (PRQC)
Design of PRQC
Participant Expectations
The Application
Next Steps

5. Goal of EMS for Children
To decrease pediatric mortality and morbidity through the integration of pediatric specific considerations into the existing emergency care system.

6. PURPOSE
To accelerate the success of the EMS for Children program through creation of active cores for quality improvement. Using an improvement science based integration model, the EIIC was designed to link tools, efforts, and entities to effectively decrease child and youth mortality and morbidity sustained as a result of illness or injury.
Pre-Hospital
Hospital Based Care
Research
Disaster Planning
Trauma
DOMAINS

7. To achieve this goal of optimal pediatric emergency care, the EIIC :
The means to facilitate the coordination of patient care across conditions, providers, settings, and time in order to achieve care that is safe, timely, effective, efficient, equitable, and patient-focused.
- AMA
To achieve this goal of optimal pediatric emergency care, the EIIC :
Identifies evidence-based, innovative, and educational strategies and tools to improve pediatric emergency care across the continuum
Strives to advance the National EMSC Performance Measures through the development and implementation of quality improvement collaboratives.
Data and Analytics
QI Science
Evidence Based Practice

8. Subject Matter Experts
WHAT WE DO Develop and implement QI collaboratives that helps states and territories implement strategies to improve EMSC state performance measures and patient outcomes
Subject Matter Experts
National Partners
AAP, ACEP, ENA
NASEMSO
NEDARC
Advanced QI Educators

9. State/Territory-Based Pediatric Readiness Programs
WHAT WE’VE DONE
FRC:
State/Territory-Based Pediatric Readiness Programs
AIM
By December 2017, increase by 50% the number of states that have developed an implementation plan to identify EDs ready to stabilize and manage children with medical emergencies based on the national Guidelines for Care of Children in the Emergency Department.

10. New Collaborative – Next Step for Pediatric Readiness
A National Pediatric Readiness Quality Collaborative (PRQC)
January 2018 – December 2019

11. BACKGROUND
EMSC Program in partnership with the American Academy of Pediatrics (AAP), American College of Emergency Physicians (ACEP), and the Emergency Nurses Association (ENA)
Goal: Ensure high quality emergency care for all children
2013 National Assessment to determine the capacity of our nation’s emergency departments to meet the needs of children (

12. 83% of EDs (4,146) across the US participated
BACKGROUND
83% of EDs (4,146) across the US participated
Presence of physician (47.5%) and nurse (59.3%) pediatric emergency care coordinators (PECC);
Presence of QI plans that include children (45.1%);
Process to ensure pediatric weights are measured in kilograms (67.7%);
Presence of inter-facility transfer guidelines (70.6%);
Presence of disaster plans that include pediatric-specific needs (46.8%).
COMMON GAPS
a.Defined process for initiation of transfer, including the roles and responsibilities of the referring facility and referral center (including responsibilities for requesting transfer and communication)
b.Process for selecting the appropriate care facility
c.Process for selecting the appropriately staffed transport service to match the patient’s acuity level (level of care required by patient, equipment needed in transport, etc.)
d.Process for patient transfer (including obtaining informed consent)
e.Plan for transfer of copy of patient medical record
f.Plan for transfer of copy of signed transport consent
g.Plan for transfer of personal belongings of the patient
h.Plan for provision of directions and referral institution
i. information to family

13. BACKGROUND
69.4% of pediatric emergency care visits in community EDs that see fewer than 15 pediatric patients per day
Presence of a PECC strongly correlated with improved pediatric readiness
Presence of a QI plan that includes pediatric-specific indicators associated with improved overall readiness

14. BACKGROUND Top 3 Barriers to Pediatric Readiness
Cost of training personnel
Lack of educational resources
Lack of a QI plan for children

15. PEDIATRIC READINESS QUALITY COLLABORATIVE January 2018 – December 2019
AIM STATEMENT By December 2019, twenty states or territory teams will collectively improve their pediatric readiness scores by 10 points.
We moved this to 10pts rather than 10% per HRSA request

16. Team Training Site Affiliate Sites
(8-12 affiliate sites per team)
Training Site
Team
Across State or Territory
A comprehensive medical center or children’s hospital that treats a high annual volume (>10,000) of pediatric patients and has an established clinical quality, patient safety, and risk management program.
Any ED/acute care hospital (may be a free standing or satellite ED) that agrees to work closely with a Training Site to implement a pediatric QI program in their emergency department.

17. PEDIATRIC CHAMPION
A physician or nurse at an Affiliate Site, identified by the site’s Hospital Administrator and ED Leadership, who agrees to implement a pediatric QI program and participate in associated team-based activities.
TRAINER
A physician or nurse at a Training site, who serves in the role of PECC, disseminates educational content to Affiliate Sites, and prepares Pediatric Champions to develop and implement a pediatric QI program.

18. INTERVENTIONS Key Areas of Focus Change Strategies
Pediatric Patient Safety
Pediatric Assessment and Reassessment
Timely, Effective, Patient- Centered Care
Disaster Planning
Recording pediatric patients’ weight in kilograms
Developing a notification process for abnormal vital signs
Integrating inter-facility transfer guidelines
Establishing disaster plans that include children

19. DATA
All training and affiliate sites should have participated in the Pediatric Readiness Assessment
Pediatric Champions will conduct chart reviews before and throughout improvement phase (rolling out interventions)
All sites must submit a data-use, data-sharing and confidentiality agreement
Secure NEDARC site
De-identified, site specific data will only be shared with the team sites
Aggregate team data will be shared with larger collaborative

20. PARTICIPANT EXPECTATION
Trainers
Participate in monthly learning sessions (1.5hrs each)
Includes 2 in-person meetings
Coordinate and lead quarterly team meetings with Affiliate Site Pediatric Champions
June December 2019
Schedule 2-3 site visits with each Affiliates during the collaborative
May occur virtually if needed
Disseminate resources, provide education and support to Pediatric Champions

21. PARTICIPANT EXPECTATION
Pediatric champion
Participate in quarterly team meetings
Facilitate 2-3 in-person or virtual site visits with team Trainer
Jan –Dec. 2019
Participate in local QI activities to include completing pediatric readiness assessment and chart reviews before and after targeted interventions

22. PARTICIPANT EXPECTATION
Hospital administrator & Ed leadership
Provide ongoing support to Trainer(s)/Pediatric Champion(s)
Agree to data sharing
Agree to identify additional Pediatric Champion/Trainer should extenuating circumstances preclude ongoing participation

23. BENEFITS OF PARTICIPATING
Letter from the HRSA EMS for Children Program acknowledging participation, achievements, and dedication to meeting the emergency care needs of children.
Mentoring by a national QI specialist and content coach
Physicians can earn Maintenance of Certification Part IV credit
Nurses can receive Continuing Nursing Education credit

24. Application Hospital Details ED Details Recent Peds Readiness Score
Type of Hospital
Designations
Geography
ED Details
Configuration
Patient Demographics
Volume of Patients & Age
Recent Peds Readiness Score
Affiliate Sites
ID Pediatric Champion
Trainer Sites
ID Trainer
Describe Experience
Letters of Commitment
Pediatric Champion
Trainer
Hospital Administrator (CEO/COO/CMO)
ED Leadership (MD/RN)

25. Application Process Action Items
Submit statement of interest –> granted access to formal application
Attend office hours and bring questions
Refer to website for updated information on the Collaborative and FAQs
Compile responses for application and secure signatures / letters of commitment
Submit questions to
Encourage others to attend additional planned webinars

26. Key Dates Application Portal Open July 10
Introductory Webinar I July 10 at 4pm CDT
Introductory Webinar II August 28 at 3pm CDT
Introductory Webinar III August 29 at 3pm CDT
Office Hours September 11 from 2-3pm CDT
Deadline to Submit Letter of Intent September 22
Office Hours September 11 from 2-3pm CDT
Office Hours September 26 from 2-3pm CDT
Office Hours October 9 from 2-3pm CDT
Office Hours October 24 from 2-3pm CDT
Deadline to Submit Application October 31 at 5pm CDT
Notification of Acceptance December 15

27. Next Steps Join PRQC Mailing List
Discuss participation with colleagues, hospital administrators, and other sites in state/territory
Review application workbook (posted on EIIC website)
Forward questions to

28. https://emscimprovement.center/categories/qi-collaboratives/
Thank You