Carlos A Camargo1, Krislyn M Boggs1, Ashley F Sullivan1, Camilo E Gutierrez2, Emory M Petrack3. 1. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 2. Department of Pediatric Emergency Medicine, Boston Medical Center, Boston, MA. 3. Department of Emergency Medicine, Floating Hospital for Children/Tufts Medical Center, Boston, MA.
Abstract
OBJECTIVES: Appointment of a pediatric emergency care coordinator (PECC) is considered the single best intervention to improve pediatric emergency care and has been recommended for all U.S. general emergency departments (EDs) for more than a decade. Unfortunately, many EDs do not adhere with this recommendation. In 2017, we performed a grassroots intervention to establish a PECC in every Massachusetts ED. METHODS: We conducted annual surveys of all 73 Massachusetts EDs from 2014 to 2018. Data collection included ED visit volumes, presence of a pediatric area, and PECC status. The intervention in 2017-2018 included e-mails and telephone calls to every ED director to not only assess PECC status but also encourage him/her to appoint one as needed. RESULTS: Survey response rates were > 85% in all years and 100% during 2016 to 2018. While Massachusetts EDs did not materially change over time (in terms of visit volumes or presence of a pediatric area), the 2017 intervention increased the percentage of EDs with an appointed PECC. Specifically, PECCs were present in approximately 30% of EDs during 2014 to 2016, climbed to 85% in 2017, and reached 100% in 2018. Most of the newly appointed PECCs were physicians. CONCLUSIONS: Through a relatively simple grassroots intervention, we increased the appointment of PECCs in Massachusetts EDs from 30% to 100%. In addition to providing PECCs with online educational materials, ongoing work is focused on building community, identifying best practices, and implementing interventions at the local level.
OBJECTIVES: Appointment of a pediatric emergency care coordinator (PECC) is considered the single best intervention to improve pediatric emergency care and has been recommended for all U.S. general emergency departments (EDs) for more than a decade. Unfortunately, many EDs do not adhere with this recommendation. In 2017, we performed a grassroots intervention to establish a PECC in every Massachusetts ED. METHODS: We conducted annual surveys of all 73 Massachusetts EDs from 2014 to 2018. Data collection included ED visit volumes, presence of a pediatric area, and PECC status. The intervention in 2017-2018 included e-mails and telephone calls to every ED director to not only assess PECC status but also encourage him/her to appoint one as needed. RESULTS: Survey response rates were > 85% in all years and 100% during 2016 to 2018. While Massachusetts EDs did not materially change over time (in terms of visit volumes or presence of a pediatric area), the 2017 intervention increased the percentage of EDs with an appointed PECC. Specifically, PECCs were present in approximately 30% of EDs during 2014 to 2016, climbed to 85% in 2017, and reached 100% in 2018. Most of the newly appointed PECCs were physicians. CONCLUSIONS: Through a relatively simple grassroots intervention, we increased the appointment of PECCs in Massachusetts EDs from 30% to 100%. In addition to providing PECCs with online educational materials, ongoing work is focused on building community, identifying best practices, and implementing interventions at the local level.
Authors: Kori S Zachrison; Emily M Hayden; Krislyn M Boggs; Tehnaz P Boyle; Jingya Gao; Margaret E Samuels-Kalow; James P Marcin; Carlos A Camargo Journal: J Med Internet Res Date: 2022-06-20 Impact factor: 7.076