RESUMEN
OBJECTIVE: To describe the impact of a national interventional collaborative on pediatric readiness within general emergency departments (EDs). STUDY DESIGN: A prospective, multicenter, interventional study measured pediatric readiness in general EDs before and after participation in a pediatric readiness improvement intervention. Pediatric readiness was assessed using the weighted pediatric readiness score (WPRS) on a 100-point scale. The study protocol extended over 6 months and involved 3 phases: (1) a baseline on-site assessment of pediatric readiness and simulated quality of care; (2) pediatric readiness interventions; and (3) a follow-up on-site assessment of WPRS. The intervention phase included a benchmarking performance report, resources toolkits, and ongoing interactions between general EDs and academic medical centers. RESULTS: Thirty-six general EDs were enrolled, and 34 (94%) completed the study. Four EDs (11%) were located in Canada, and the rest were in the US. The mean improvement in WPRS was 16.3 (P < .001) from a baseline of 62.4 (SEM = 2.2) to 78.7 (SEM = 2.1), with significant improvement in the domains of administration/coordination of care; policies, protocol, and procedures; and quality improvement. Six EDs (17%) were fully adherent to the protocol timeline. CONCLUSIONS: Implementing a collaborative intervention model including simulation and quality improvement initiatives is associated with improvement in WPRS when disseminated to a diverse group of general EDs partnering with their regional pediatric academic medical centers. This work provides evidence that innovative collaboration facilitated by academic medical centers can serve as an effective strategy to improve pediatric readiness and processes of care.
Asunto(s)
Servicio de Urgencia en Hospital/normas , Pediatría , Mejoramiento de la Calidad , Niño , Humanos , Estudios ProspectivosRESUMEN
The SARS CoV-2 pandemic brought unique challenges to healthcare workers and systems. Simulation teams improvised and scaled up to meet new educational needs. Children's hospitals worked to address the many issues surrounding COVID-19, including how to prepare facilities and staff to care for adult patients in the event of COVID patient overflow. This technical report describes the use of the teaching method rapid cycle deliberate practice (RCDP) to train interprofessional teams unaccustomed to working together. We detail how sessions were developed and implemented, particularly noting the need for an extended pre-briefing to optimize psychological safety. The RCDP model allowed for a high level of interaction throughout the simulations and the incorporation of new knowledge "on the go" during the sessions.