In this Issue:

• Preparing the Emergency Department for Pediatric Patients
• Best Practices: Child-Ready Emergency Departments: Creating Customized Pediatric Facilities, Equipment, and Care
• Innovations: Educational Toolkit for Pediatric Emergency Preparedness
• Perspectives: Leadership Needed: Hospitals Must Work Together to Improve Pediatric Emergency Care
• In the News: ACEP Reports on the Growing Interest in Pediatric Emergency Medicine, Newsweek Examines Efforts to Alleviate ED Crowding & CMS Issues a Memorandum on Provision of Emergency Services

Preparing the Emergency Department for Pediatric Patients

On June 14, 2006, the Institute of Medicine (IOM) released a report on pediatric emergency care highlighting that only 6 percent of emergency departments (EDs) in the United States are fully equipped to handle pediatric patients, even though 27 percent of all ED visits involve children. Hospitals across the nation are challenged to meet the unique medical needs of children in the ED. Emergency providers often feel anxious when treating pediatric patients due to communication barriers and lack of treatment standards and proper equipment. The resulting variability in care increases the risk of medical and medication errors for pediatric patients.

Hospitals and professional associations are creating innovative strategies to address the special needs of pediatric patients. The American College of Emergency Physicians and the American Academy of Pediatrics have created a toolkit that enables hospitals to train staff, institute policies regarding the treatment of pediatric patients, and provide quick guides for providers on medication dosing. This newsletter highlights both hospital-level and nationwide strategies that hospitals can implement to treat their pediatric patients with safe and high-quality care.
 

Best Practices
Child-Ready Emergency Departments: Creating Customized Pediatric Facilities, Equipment, and Care

To strengthen pediatric emergency care, hospitals around the country are investing in customized facilities and equipment, hiring ED physicians and nurses with pediatric experience, and retraining other staff. Some are even creating kids-only emergency departments. While most hospitals can't afford separate departments, there are simple steps all hospitals can take to prepare for pediatric emergencies. Bernard Dannenberg and Paula Miller discuss the ED at Lucile Packard Hospital at Stanford that has been customized for pediatric patients. Better management of pediatric emergencies could help hospitals to alleviate overcrowding and improve patient flow.

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Innovations
Educational Toolkit for Pediatric Emergency Preparedness

In 2001, the American College of Emergency Physicians (ACEP) and the American Academy of Pediatrics (AAP) published guidelines on pediatric emergency preparedness for hospital EDs, detailing the equipment, staff, and policies required to ensure the safest and highest-quality care. To help hospitals implement the guidelines, the AAP and ACEP developed a toolkit on pediatric emergency care--one of the few resources available to help community hospitals prepare to care for seriously injured or sick children and adolescents. In this article, Marianne Gausche-Hill describes the elements of the toolkit and a process evaluation to determine its effectiveness.

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Perspectives
Leadership Needed: Hospitals Must Work Together to Improve Pediatric Emergency Care

Children are not simply small adults and certainly cannot be treated as such. They are typically more fearful than adult patients, and their treatment often requires proficiency in the use of smaller-sized equipment, knowledge of weight-based medication administration and familiarity with the nuances of child development from infancy through adolescence. Joseph L. Wright of Children's National Medical Center in Washington, D.C. explains why and how our nation's emergency departments can improve the provision of pediatric emergency care.

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In the News

ACEP Reports on the Growing Interest in Pediatric Emergency Medicine
In February 2007, the American College of Emergency Physicians reported that pediatric emergency medicine has become the third most popular pediatric subspecialty choice. Since 1997, the number of fellows enrolled in pediatric emergency medicine programs has increased 64 percent.

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Newsweek Examines Efforts to Alleviate ED Crowding
Newsweek has released a series of articles highlighting hospital strategies to alleviate ED crowding. Additionally, the articles described federal government efforts to address the problem of crowding that is evident in many hospitals across the country.

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Centers for Medicare & Medicaid Services Memorandum
In April 2007, the Centers for Medicare & Medicaid Services (CMS) issued a memorandum that provides guidance to hospitals participating in Medicare regarding their capability to provide basic emergency care interventions. The memorandum affirms that all hospitals (except Critical Access Hospitals) must provide a foundation for safe care for all persons, including those with emergency care needs regardless of whether the hospital has an emergency department.

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