The Impact of a Pediatric Emergency Department Facility Verification System on Pediatric Mortality Rates in Arizona

Amber Rice, Jennifer Dudek, Toni Gross, Tomi St Mars, Dale P Woolridge

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: The Emergency Medical Services for Children State Partnership Program, as well as the Institute of Medicine report on pediatric emergency care, encourages recognition of emergency departments (EDs) through categorization and verification systems. Although pediatric verification programs are associated with greater pediatric readiness, clinical outcome data have been lacking to track the effects and patient-centered outcomes by implementing such programs. Objective: To describe pediatric mortality rates prior to and after implementation of a pediatric emergency facility verification system in Arizona. Methods: This was a cross-sectional study conducted using data from ED visits between 2011 and 2014 recorded in the Arizona Hospital Discharge Database. The primary outcome measure was the mortality rate for ED visits by patients under 18 years old. Rates were compared prior to and after facility certification by the Arizona Pediatric Prepared Emergency Care program. Results: The total number of ED visits by children during the study period was 1,928,409. Of these, 1,127,294 were at facilities undergoing certification. For hospitals becoming certified, overall ED mortality rates were 35.2 deaths/100,000 ED visits (95% confidence interval [CI] 29.5-41.7) in the precertification analysis and 34.4 deaths/100,000 ED visits (95% CI 30.4-38.9) in the postcertification analysis. The injury-related ED visit mortality rate for certified hospitals showed a decrease from 40.0 injury-related deaths/100,000 ED visits (95% CI 28.6-54.4) in the precertification analysis to 25.8 injury-related deaths/100,000 ED visits (95% CI 18.7-34.8) in the postcertification analysis. Conclusion: The implementation of the Arizona pediatric ED verification system was associated with a trend toward lower mortality. These results offer a platform for further research on pediatric ED preparedness efforts and their effects on improved patient outcomes.

Original languageEnglish (US)
JournalJournal of Emergency Medicine
DOIs
StateAccepted/In press - Oct 8 2016

Fingerprint

Hospital Emergency Service
Pediatrics
Mortality
Emergency Medical Services
Confidence Intervals
Certification
Wounds and Injuries
Civil Defense
National Academies of Science, Engineering, and Medicine (U.S.) Health and Medicine Division
Emergencies
Cross-Sectional Studies
Outcome Assessment (Health Care)
Databases

Keywords

  • Facility verification
  • Injury mortality
  • Institute of Medicine
  • Mortality rates
  • Pediatric emergency care
  • Pediatric Prepared Emergency Care
  • Trauma systems

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

The Impact of a Pediatric Emergency Department Facility Verification System on Pediatric Mortality Rates in Arizona. / Rice, Amber; Dudek, Jennifer; Gross, Toni; St Mars, Tomi; Woolridge, Dale P.

In: Journal of Emergency Medicine, 08.10.2016.

Research output: Contribution to journalArticle

@article{94d5fae1de274bdeb8b21300528ef7cf,
title = "The Impact of a Pediatric Emergency Department Facility Verification System on Pediatric Mortality Rates in Arizona",
abstract = "Background: The Emergency Medical Services for Children State Partnership Program, as well as the Institute of Medicine report on pediatric emergency care, encourages recognition of emergency departments (EDs) through categorization and verification systems. Although pediatric verification programs are associated with greater pediatric readiness, clinical outcome data have been lacking to track the effects and patient-centered outcomes by implementing such programs. Objective: To describe pediatric mortality rates prior to and after implementation of a pediatric emergency facility verification system in Arizona. Methods: This was a cross-sectional study conducted using data from ED visits between 2011 and 2014 recorded in the Arizona Hospital Discharge Database. The primary outcome measure was the mortality rate for ED visits by patients under 18 years old. Rates were compared prior to and after facility certification by the Arizona Pediatric Prepared Emergency Care program. Results: The total number of ED visits by children during the study period was 1,928,409. Of these, 1,127,294 were at facilities undergoing certification. For hospitals becoming certified, overall ED mortality rates were 35.2 deaths/100,000 ED visits (95{\%} confidence interval [CI] 29.5-41.7) in the precertification analysis and 34.4 deaths/100,000 ED visits (95{\%} CI 30.4-38.9) in the postcertification analysis. The injury-related ED visit mortality rate for certified hospitals showed a decrease from 40.0 injury-related deaths/100,000 ED visits (95{\%} CI 28.6-54.4) in the precertification analysis to 25.8 injury-related deaths/100,000 ED visits (95{\%} CI 18.7-34.8) in the postcertification analysis. Conclusion: The implementation of the Arizona pediatric ED verification system was associated with a trend toward lower mortality. These results offer a platform for further research on pediatric ED preparedness efforts and their effects on improved patient outcomes.",
keywords = "Facility verification, Injury mortality, Institute of Medicine, Mortality rates, Pediatric emergency care, Pediatric Prepared Emergency Care, Trauma systems",
author = "Amber Rice and Jennifer Dudek and Toni Gross and {St Mars}, Tomi and Woolridge, {Dale P}",
year = "2016",
month = "10",
day = "8",
doi = "10.1016/j.jemermed.2017.02.011",
language = "English (US)",
journal = "Journal of Emergency Medicine",
issn = "0736-4679",
publisher = "Elsevier USA",

}

TY - JOUR

T1 - The Impact of a Pediatric Emergency Department Facility Verification System on Pediatric Mortality Rates in Arizona

AU - Rice, Amber

AU - Dudek, Jennifer

AU - Gross, Toni

AU - St Mars, Tomi

AU - Woolridge, Dale P

PY - 2016/10/8

Y1 - 2016/10/8

N2 - Background: The Emergency Medical Services for Children State Partnership Program, as well as the Institute of Medicine report on pediatric emergency care, encourages recognition of emergency departments (EDs) through categorization and verification systems. Although pediatric verification programs are associated with greater pediatric readiness, clinical outcome data have been lacking to track the effects and patient-centered outcomes by implementing such programs. Objective: To describe pediatric mortality rates prior to and after implementation of a pediatric emergency facility verification system in Arizona. Methods: This was a cross-sectional study conducted using data from ED visits between 2011 and 2014 recorded in the Arizona Hospital Discharge Database. The primary outcome measure was the mortality rate for ED visits by patients under 18 years old. Rates were compared prior to and after facility certification by the Arizona Pediatric Prepared Emergency Care program. Results: The total number of ED visits by children during the study period was 1,928,409. Of these, 1,127,294 were at facilities undergoing certification. For hospitals becoming certified, overall ED mortality rates were 35.2 deaths/100,000 ED visits (95% confidence interval [CI] 29.5-41.7) in the precertification analysis and 34.4 deaths/100,000 ED visits (95% CI 30.4-38.9) in the postcertification analysis. The injury-related ED visit mortality rate for certified hospitals showed a decrease from 40.0 injury-related deaths/100,000 ED visits (95% CI 28.6-54.4) in the precertification analysis to 25.8 injury-related deaths/100,000 ED visits (95% CI 18.7-34.8) in the postcertification analysis. Conclusion: The implementation of the Arizona pediatric ED verification system was associated with a trend toward lower mortality. These results offer a platform for further research on pediatric ED preparedness efforts and their effects on improved patient outcomes.

AB - Background: The Emergency Medical Services for Children State Partnership Program, as well as the Institute of Medicine report on pediatric emergency care, encourages recognition of emergency departments (EDs) through categorization and verification systems. Although pediatric verification programs are associated with greater pediatric readiness, clinical outcome data have been lacking to track the effects and patient-centered outcomes by implementing such programs. Objective: To describe pediatric mortality rates prior to and after implementation of a pediatric emergency facility verification system in Arizona. Methods: This was a cross-sectional study conducted using data from ED visits between 2011 and 2014 recorded in the Arizona Hospital Discharge Database. The primary outcome measure was the mortality rate for ED visits by patients under 18 years old. Rates were compared prior to and after facility certification by the Arizona Pediatric Prepared Emergency Care program. Results: The total number of ED visits by children during the study period was 1,928,409. Of these, 1,127,294 were at facilities undergoing certification. For hospitals becoming certified, overall ED mortality rates were 35.2 deaths/100,000 ED visits (95% confidence interval [CI] 29.5-41.7) in the precertification analysis and 34.4 deaths/100,000 ED visits (95% CI 30.4-38.9) in the postcertification analysis. The injury-related ED visit mortality rate for certified hospitals showed a decrease from 40.0 injury-related deaths/100,000 ED visits (95% CI 28.6-54.4) in the precertification analysis to 25.8 injury-related deaths/100,000 ED visits (95% CI 18.7-34.8) in the postcertification analysis. Conclusion: The implementation of the Arizona pediatric ED verification system was associated with a trend toward lower mortality. These results offer a platform for further research on pediatric ED preparedness efforts and their effects on improved patient outcomes.

KW - Facility verification

KW - Injury mortality

KW - Institute of Medicine

KW - Mortality rates

KW - Pediatric emergency care

KW - Pediatric Prepared Emergency Care

KW - Trauma systems

UR - http://www.scopus.com/inward/record.url?scp=85015782593&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85015782593&partnerID=8YFLogxK

U2 - 10.1016/j.jemermed.2017.02.011

DO - 10.1016/j.jemermed.2017.02.011

M3 - Article

C2 - 28341087

AN - SCOPUS:85015782593

JO - Journal of Emergency Medicine

JF - Journal of Emergency Medicine

SN - 0736-4679

ER -