Researchers at UC Davis Health System will study the quality of health care delivered to children in emergency departments throughout the United States through a new, three-year $1.4 million grant from the U.S. Department of Health and Human Services.
“We need good measures of emergency care, and of emergency room care for children in particular,” said James Marcin, professor of pediatric critical care medicine at the UC Davis School of Medicine and the co-principal investigator for the study. “While some quality instruments have been developed for pediatric emergency care, few have been tested or applied as we’re proposing on such a large scale.”
The study, funded through the Agency for Healthcare Research and Quality, will examine the effectiveness of the Pediatric Emergency Department Quality Assessment Tool, developed at UC Davis and used to successfully identify factors associated with quality of care in a small group of rural Northern California emergency departments with very sick pediatric patients.
The study will expand the research to include more than 600 diverse pediatric patients in 12 emergency departments in the Pediatric Emergency Care Applied Research Network (PECARN), the only federally funded pediatric emergency care research network in the U.S.
PECARN is organized into four research nodes, including one led by UC Davis. The study will retrospectively review the medical records of children presenting to PECARN emergency departments, with records randomly selected from three hospitals in each of the research nodes.
The researchers will review the records for quality of care using the instrument, which assesses initial data-gathering about acute problems; integration of information and development of appropriate diagnoses; the initial treatment plan and orders, and the plan for patient disposition and follow-up.
The study will also identify whether such factors as emergency department volume, type of emergency department and physician training are associated with differences in the quality of pediatric emergency care.
“Once validated across a large and diverse sample, this tool will assist in the identification of areas where emergency departments can make a significant, positive difference in quality of care for children,” said Madan Dharmar, study co-principal investigator and assistant research professor in the UC Davis Department of Pediatrics.
Other study investigators include Nathan Kuppermann, professor and chair of emergency medicine, and Patrick Romano, professor of internal medicine and pediatrics and a noted quality-of-care expert. PECARN is funded by the Health Resources and Services Administration, the Maternal and Child Health Bureau and the Emergency Medical Services for Children Program.