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Improving Emergency Preparedness in Pediatric Primary Care Offices: A Simulation-Based Interventional Study

  • Matthew L. Yuknis
    Correspondence
    Address correspondence to Matthew L, Yuknis, MD, FAAP, Department of Pediatrics, Division of Pediatric Critical Care, Riley Hospital for Children at IU Health, 705 Riley Hospital Drive, Phase 2, Room 4900, Indianapolis, IN 46202-5225
    Affiliations
    Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine and Riley Hospital for Children at Indiana University Health (ML Yuknis and K Abulebda), Indianapolis, Ind 46202-5225
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  • Kamal Abulebda
    Affiliations
    Division of Pediatric Critical Care Medicine, Department of Pediatrics, Indiana University School of Medicine and Riley Hospital for Children at Indiana University Health (ML Yuknis and K Abulebda), Indianapolis, Ind 46202-5225
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  • Travis Whitfill
    Affiliations
    Departments of Pediatrics and Emergency Medicine, Yale School of Medicine (T Whitfill and MA Auerbach), New Haven, Conn, 06511
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  • Kellie J. Pearson
    Affiliations
    Lifeline Critical Care Transport, Indiana University Health (KJ Pearson and EE Montgomery), Indianapolis, Ind 46222
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  • Erin E. Montgomery
    Affiliations
    Lifeline Critical Care Transport, Indiana University Health (KJ Pearson and EE Montgomery), Indianapolis, Ind 46222
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  • Marc A. Auerbach
    Affiliations
    Departments of Pediatrics and Emergency Medicine, Yale School of Medicine (T Whitfill and MA Auerbach), New Haven, Conn, 06511
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  • on behalf ofImproving Pediatric Acute Care Through Simulation (ImPACTS)
Published:March 30, 2022DOI:https://doi.org/10.1016/j.acap.2022.03.018

      Abstract

      Objectives

      Pediatric emergencies pose a challenge to primary care practices due to irregular frequency and complexity. Simulation-based assessment can improve skills and comfort in emergencies. Our aim was improving pediatric office emergency preparedness, as measured by adherence to the existing American Academy of Pediatrics policy statement, and quality of emergency care in a simulated setting, as measured by performance checklists.

      Methods

      This was a single center study nested in a multicenter, prospective study measuring emergency preparedness and quality of care in 16 pediatric primary care practices and consisted of 3 phases: baseline assessment, intervention, and follow-up assessment. Baseline emergency preparedness was measured by checklist based on AAP guidelines, and quality of care was assessed using in-situ simulation. A report-out was provided along with resources addressing potential areas for improvement after baseline assessment. A repeat preparedness and simulation assessment was performed after a 6 to 10 month intervention period to measure improvement from baseline.

      Results

      Sixteen offices were recruited with 13 completing baseline and follow-up preparedness assessment. Eight of these sites also completed baseline and follow-up simulation assessment. Median baseline preparedness score was 70% and follow-up was 75.9%. Median baseline simulation performance scores were 37.4% and 35.5% for respiratory distress and seizure scenarios, respectively. Follow-up simulation assessment scores were 73% and 76.9% respectively (P = .001).

      Conclusions

      Our collaborative was able to successfully improve the quality of care in a simulated setting in a group of pediatric primary care offices over 6 to 10 months. Future work will focus on expansion and improving emergency preparedness.

      Keywords

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