How the Heck Does a PECC Improve Pediatric Readiness: A Quality Improvement Collaborative

Aim: : Having a designated pediatric emergency care coordinator (PECC)/champion has increased the weighted pediatric readiness score (wPRS) in EDs. High wPR’s directly correlated to improved outcomes for pediatric patients, demonstrating a 4-fold lower mortality rate for children.
The Pediatric emergency care coordinator Workforce Development Collaborative (PWDC) highlights the significant impact PECCs have on pediatric readiness and how quality improvement initiatives can improve outcomes.
PWDC had two aims:
By March 2021, 100% of participants in phase 1 will have identified at least one strategy to improve pediatric readiness within their organization.
By June 30, 2022, 90% of participants in phase 2 will design and implement a quality improvement project that aligns with Pediatric Readiness.

Framework:: The PWDC followed the Institute for Healthcare Improvement’s (IHI) Model for Improvement. Participants were exposed to the IHI framework to guide improvement work. Learning sessions introduced concepts including; building your team, setting aims, creating key drivers, and how to begin making change.
Phase two participants received coaching sessions and QI tools to help them develop an improvement project. Projects were from one of the following four areas: formalizing PECC role; securing pediatric equipment/supplies/medications; developing pediatric competencies; or developing a policy/protocol/pathway/decision support tool. PWDC team members worked with participants to define a measurement strategy and supported participants as they made iterative changes using rapid plan-study-do-act cycles.

Setting:: The QI collaborative was open to individual interested in improving the quality of pediatric emergency care in the emergency department, prehospital setting, or their region.

Stakeholder Team:: Subject matter experts in pediatric readiness and quality improvement methodology hosted and facilitated learning and coaching sessions. The initiative was led by an executive team of nurses, physicians, prehospital professionals and supported by a project manager.

Methods: : Phase 1 explored pediatric readiness-focused areas through a QI lens and role-specific breakout sessions. Participants examined best practices that role-specific PECCs from around the country. Survey reporting identified areas for improvement related to pediatric readiness. A personal dashboard tracked their progress.
Data analysis focused on the number of participants and their role, completion rate of the environmental scan, identification of gaps in their current state of pediatric readiness, and changes in knowledge of pediatric readiness and quality improvement methods. Phase two analysis focused on the percentage of participants that submitted project descriptions, smart aims, and change strategies.

Outcomes:: 1491 participants registered for the collaborative and 1370 participants remained throughout phase one of the PWDC representing 610 EMS practitioners, 482 nurses or other healthcare professionals, 165 physicians or advanced practice providers, 79 EMSC State Partnership program team members, and 34 participants listed as other/unsure. Phase two had 135 participants. We continue evaluation of survey results and data.

Implications:: The PWDC empowered pediatric champions from the nation and the emergency care continuum to drive pediatric readiness efforts through coaching, networking opportunities, quality improvement methodology and shared learning to drive the best evidence into practice. Predicted outcomes include increased knowledge of the seven domains of pediatric readiness, quality improvement science, and implementation of quality improvement practices through phase two projects.