Intervention Title:
Utilizing a Pediatric Emergency Preparedness Toolkit, Harbor-UCLA Medical Center; Torrance, Calif.

Goal:
Encourage emergency departments to meet the national standards for pediatric emergency care issued by the American College of Emergency Physicians (ACEP) and the American Academy of Pediatrics (AAP).  

Innovation:
Implemented use of the “Care of Children in the Emergency Department: Guidelines for Preparedness Implementation” toolkit to improve the quality of care provided to children. This is a widely available, but frequently unused source for uniform pediatric emergency guidelines from the ACEP.

Result:
While the impact of the program is still being reviewed, it is clear that more hospital emergency staff are aware of the toolkit and routinely referring to it.

Institution:
Harbor-UCLA Medical Center
1000 West Carson Street
Torrance, CA 90502

From the Leadership: 

“Any hospital can use the tools in the emergency preparedness toolkit, yet many don’t. Our own experience shows that appointing a Pediatrics Emergency Medicine Coordinator to help implement the toolkit strategies can be especially effective.”  

Robert Hockberger, M.D.
Chair, Department of Emergency Medicine

Profile:
Publicly owned, 322-bed teaching hospital. 

Clinical areas affected:

• Emergency department 

Staff involved:

• Emergency medical technicians
• Emergency nurses
• Emergency physicians

Timeline:
Implementing all of the recommendations in the Pediatric Emergency Preparedness Toolkit took approximately two years.    

Contact:
Marianne Gausche-Hill, M.D., F.A.C.E.P., F.A.A.P.
Professor of Medicine
mgausche@emedharbor.edu 
P: (310) 782-1763

Innovation implementation:
Emergency pediatric care becomes very challenging because children of various sizes and ages each require unique types of care and specific doses of medicine. Unfortunately, managing this type of care requires more than proper training—it requires having the right tools and the right set of processes in place to ensure high-quality care. 

Using the toolkit, hospitals can improve the overall quality of pediatric emergency care across the country by meeting national guidelines for care issued by ACEP and the AAP. Implementing the toolkit at Harbor-UCLA required the buy-in of hospital staff, which was obtained quickly. In order to continue to maintain a high standard of pediatric emergency care, HARBOR-UCLA developed a Community Council, which now meets monthly and is comprised of members of the hospital’s pediatric and emergency staff, including the director of the Pediatric Emergency Department, nurse manager for Pediatrics and the Pediatric ED, nurse practitioners, hospital administrators, the pre-hospital director, and fellows in pediatric emergency medicine.

Advice and lessons learned:

1. Assign someone the role of Pediatrics Emergency Medicine Coordinator. Without someone in place to manage pediatric emergency care, using the toolkit to improve the quality of care will be difficult. 
2. Assign someone the role of Nursing Coordinator. A nursing coordinator to implement many of the toolkit’s recommendations will help to improve the quality of care more quickly.  

Cost/benefit estimate:  
While the cost/benefit analysis is still being determined, the average cost for implementing the toolkit is relatively minimal, about $2,000—half of which is the cost of necessary equipment.