Hospital emergency departments (EDs) are better prepared to care for children than they were in previous years, according to a web-based assessment of more than 4,100 EDs in the United States; however, there is still room to improve both the availability of pediatric-specific equipment and disaster planning to address children's needs. The findings from the survey, which was conducted in 2013, were published online April 13, 2015, in JAMA Pediatrics. The study found that the median weighted pediatric readiness score for the hospital EDs was 68.9 (out of a possible score of 100), compared with a previously reported score of 55 in 2003. The hospital EDs surveyed had about 91% of the recommended pediatric equipment available (as specified in 2009 guidelines), and nearly all of them had trained staff on the location of the equipment. About 15% of the EDs lacked one or more equipment items listed in the guidelines. Additionally, just under half (47%) of the responding hospital EDs had disaster plans tailored to pediatric patients. Pediatric readiness was more likely if the hospital ED had a physician or nurse pediatric emergency care coordinator, who addresses issues such as staff training, equipment availability, and policies for caring for children. About half of the surveyed EDs had such a coordinator. The survey was conducted by a coalition of three professional organizations (i.e., American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nurses Association) and the Health Resources and Services Administration's Emergency Medical Services for Children, which formed the National Pediatric Readiness Project to target improvements for hospital ED pediatric readiness.

HRC Recommends: Most children in the United States are cared for in EDs that are located in general hospitals rather than children's hospitals. Patient care suffers when providers are not clinically prepared and do not have the necessary resources to care for pediatric patients. Risk managers should work with ED clinical and management leadership to help the organization identify and address any gaps in its provision of emergency care to children. Perhaps the most important key to providing safe and effective care to children in the ED is to appoint a physician and nurse coordinator for pediatric emergency care.