{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T06:23:34Z","timestamp":1790749414553,"version":"4.1.0"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,11,13]],"date-time":"2017-11-13T00:00:00Z","timestamp":1510531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Indiana University Health Values Fund","award":["VFE-332"],"award-info":[{"award-number":["VFE-332"]}]},{"name":"Indiana University School of Medicine Department of Pediatrics","award":["RCF-15-A2"],"award-info":[{"award-number":["RCF-15-A2"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2018,2]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>More than 30 million children are cared for across 5,000 U.S. emergency departments (ED<\/jats:styled-content>s) each year. Most of these ED<\/jats:styled-content>s are not facilities designed and operated solely for children. A Web\u2010based survey provided a national and state\u2010by\u2010state assessment of pediatric readiness and noted a national average score was 69 on a 100\u2010point scale. This survey noted wide variations in ED<\/jats:styled-content> readiness with scores ranging from 61 in low\u2010pediatric\u2010volume ED<\/jats:styled-content>s to 90 in the high\u2010pediatric\u2010volume ED<\/jats:styled-content>s. Additionally, the mean score at the state level ranged from 57 (Wyoming) to 83 (Florida) and for individual ED<\/jats:styled-content>s ranged from 22 to 100. The majority of prior efforts made to improve pediatric readiness have involved providing Web\u2010based resources and online toolkits. This article reports on the first year of a program that aimed to improve pediatric readiness across community hospitals in our state through in\u00a0situ simulation\u2010based assessment facilitated by our academic medical center. The primary aim was to improve the pediatric readiness scores in the 10 participating hospitals. The secondary aim was to explore the correlation of simulation\u2010based performance of hospital teams with pediatric readiness scores.<\/jats:p><\/jats:sec>Methods<\/jats:title>This interventional study measured the Pediatric Readiness Survey (PRS<\/jats:styled-content>) prior to and after implementation of an improvement program. This program consisted of three components: 1) in\u00a0situ simulations, 2) report\u2010outs, and 3) access to online pediatric readiness resources and content experts. The simulations were conducted in\u00a0situ (in the ED<\/jats:styled-content> resuscitation bay) by multiprofessional teams of doctors, nurses, respiratory therapists, and technicians. Simulations and debriefings were facilitated by an expert team from a pediatric academic medical center. Three scenarios were conducted for all teams and include: a 6\u2010month\u2010old with respiratory failure, an 8\u2010year\u2010old with diabetic ketoacidosis (DKA<\/jats:styled-content>), and a 6\u2010month\u2010old with supraventricular tachycardia (SVT<\/jats:styled-content>). A performance score was calculated for each scenario. The improvement of PRS<\/jats:styled-content> was compared before and after the simulation program. The correlation of the simulation performance of each hospital and the PRS<\/jats:styled-content> was calculated.<\/jats:p><\/jats:sec>Results<\/jats:title>Forty\u2010one multiprofessional teams from 10 ED<\/jats:styled-content>s in Indiana participated in the study, five were of medium pediatric volume and five were medium\u2010 to high\u2010volume ED<\/jats:styled-content>s. The PRS<\/jats:styled-content> significantly improved from the first to the second on\u2010site verification assessment (58.4\u00a0\u00b1\u00a04.8 to 74.7\u00a0\u00b1\u00a02.9, p\u00a0=\u00a00.009). Total adherence scores to scenario guidelines were 54.7, 56.4, and 62.4% in the respiratory failure, DKA<\/jats:styled-content>, and SVT<\/jats:styled-content> scenarios, respectively. We found no correlation between simulation performance and PRS<\/jats:styled-content> scores. Medium ED<\/jats:styled-content> pediatric volume significantly predicted higher PRS<\/jats:styled-content> scores compared to medium\u2010high pediatric ED<\/jats:styled-content> volume (\u03b2\u00a0=\u00a08.7; confidence interval\u00a0= 0.72\u201316.8, p\u00a0=\u00a00.034).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Our collaborative improvement program that involved simulation was associated with improvement in pediatric readiness scores in 10 ED<\/jats:styled-content>s participating statewide. Future work will focus on further expanding of the network and establishing a national model for pediatric readiness improvement.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.13329","type":"journal-article","created":{"date-parts":[[2017,10,4]],"date-time":"2017-10-04T19:06:41Z","timestamp":1507144001000},"page":"177-185","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":72,"title":["A Collaborative In Situ Simulation\u2010based Pediatric Readiness Improvement Program for Community Emergency Departments"],"prefix":"10.1111","volume":"25","author":[{"given":"Kamal","family":"Abulebda","sequence":"first","affiliation":[{"name":"Department of Pediatrics Riley Hospital for Children at Indiana University Health Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riad","family":"Lutfi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Riley Hospital for Children at Indiana University Health Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Travis","family":"Whitfill","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Yale University School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samer","family":"Abu\u2010Sultaneh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Riley Hospital for Children at Indiana University Health Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kellie J.","family":"Leeper","sequence":"additional","affiliation":[{"name":"LifeLine Critical Care Transport Indiana University Health Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Weinstein","sequence":"additional","affiliation":[{"name":"Division of Emergency Medicine Indiana University School of Medicine Indianapolis IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc A.","family":"Auerbach","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine Yale University School of Medicine New Haven CT"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,13]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Healthcare Cost and Utilization Project (HCUP) Statistical Briefs","author":"Wier LM","year":"2006"},{"key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1542\/peds.107.4.777","article-title":"Committee on Pediatric Emergency Medicine and American College of Emergency Physicians, and Pediatric Committee. 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Accessed Sep 19 2017."},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.114.1.157"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2015.07.500"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000001233"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0000000000000150"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2012-000951"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2007.03.009"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000000297"},{"key":"e_1_2_8_17_1","unstructured":"Pediatric Readiness: National Results.Emergency Medical Services for Children Innovation & Improvement Center. Available at:https:\/\/emscimprovement.center\/projects\/pediatricreadiness\/results-and-findings\/national-results\/. Accessed Sep 19 2017."},{"key":"e_1_2_8_18_1","unstructured":"Program Overview & Goals.Indiana University School of Medicine.http:\/\/pediatrics.iu.edu\/neonatal-perinatal-medicine\/programs\/simulation-instructor-course\/program-overview-and-goals\/. 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