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Emergency Department Pediatric Readiness Tied to Patient Death Rates


A study in the September 2019 Pediatrics, “Emergency Department Pediatric Readiness and Mortality in Critically Ill Children,” found that the hospital a child is taken to for emergency care affects their odds of survival.  Researchers studied health outcomes data from 20,483 critically ill infants, children, and teens brought to 426 hospitals in Florida, Iowa, Massachusetts, Nebraska, and New York. They compared it to hospital-specific data from the 2013 National Pediatric Readiness Project, a multi-phase quality improvement initiative aimed at ensuring all U.S. emergency departments can provide effective emergency care to children. After adjusting for age, chronic complex conditions, and severity of illness, the researchers found that children seen in emergency departments ranked in the top 25 percent of pediatric readiness scores had a significantly decreased odds of dying in the hospital. The majority of U.S. emergency departments may not be prepared to care for children, the authors said, because they lack core elements of pediatric readiness such as available staff trained for the unique needs of children and appropriately sized and dosed equipment and medication. Most U.S. children live farther than 30 miles from a facility with a high pediatric readiness score, suggesting geographic disparities in access to high-quality emergency care. The authors said pediatric-focused policies and other efforts such collaborating at the state and local level to provide shared resources and appointing pediatric emergency care coordinators can help improve medical outcomes, particularly for high-risk children.

Editor’s note: The solicited commentary, “The Time Is Now: Uncovering the Value of Pediatric Readiness in Emergency Departments,” accompanies this study.


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit and follow us on Twitter @AmerAcadPeds