“Right now, it's kind of haphazard”—Pediatric emergency care coordinators and quality of emergency care for children: A qualitative study
Abstract Objectives Pediatric readiness varies widely among emergency departments (EDs). The presence of a pediatric emergency care coordinator (PECC) has been associated with improved pediatric readiness and decreased mortality, but adoption of PECCs has been limited. Our objective was to understan...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-06-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.13108 |
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| author | Margaret Samuels‐Kalow Krislyn M. Boggs Stephanie S. Loo Maeve F. Swanton William A. Manning Rebecca E. Cash Courtney B. Wolk Elizabeth R. Alpern Kenneth A. Michelson Katherine E. Remick Carlos A. Camargo Jr. |
| author_facet | Margaret Samuels‐Kalow Krislyn M. Boggs Stephanie S. Loo Maeve F. Swanton William A. Manning Rebecca E. Cash Courtney B. Wolk Elizabeth R. Alpern Kenneth A. Michelson Katherine E. Remick Carlos A. Camargo Jr. |
| author_sort | Margaret Samuels‐Kalow |
| collection | DOAJ |
| description | Abstract Objectives Pediatric readiness varies widely among emergency departments (EDs). The presence of a pediatric emergency care coordinator (PECC) has been associated with improved pediatric readiness and decreased mortality, but adoption of PECCs has been limited. Our objective was to understand factors associated with PECC implementation in general EDs. Methods We conducted semistructured qualitative interviews with a purposively sampled set of EDs with and without PECCs. Interviews were completed, transcribed, and coded until thematic saturation was reached. Themes were identified through a consensus process and mapped to the Consolidated Framework for Implementation Research (CFIR). Results Twenty‐four interviews were conducted and mapped to themes related to innovation, individuals and implementation process, outer setting (health system), and inner setting (hospital/ED). Addressing innovation, individuals, and implementation process, the primary theme was variability in how the PECC role was defined and who was responsible for implementing it. Regarding the outer setting, participants reported that limited system resources affected their ability to implement the PECC role. Key inner setting themes included concerns about limited visit volume, a lack of systems for measuring pediatric quality of care, and significant tension around change. Conclusions Implementation of the PECC role appears to be limited by heterogeneous interpretations of the PECC, de‐prioritization of pediatrics, and limited system resources. However, many participants described motivation to improve pediatric care and implement the PECC role in context of increasing pediatric visits; they offered strategies for future implementation efforts. |
| format | Article |
| id | doaj-art-0155144cabd8471ca4d43da0a8822901 |
| institution | Kabale University |
| issn | 2688-1152 |
| language | English |
| publishDate | 2024-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-0155144cabd8471ca4d43da0a88229012025-08-20T03:55:27ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522024-06-0153n/an/a10.1002/emp2.13108“Right now, it's kind of haphazard”—Pediatric emergency care coordinators and quality of emergency care for children: A qualitative studyMargaret Samuels‐Kalow0Krislyn M. Boggs1Stephanie S. Loo2Maeve F. Swanton3William A. Manning4Rebecca E. Cash5Courtney B. Wolk6Elizabeth R. Alpern7Kenneth A. Michelson8Katherine E. Remick9Carlos A. Camargo Jr.10Department of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USADepartment of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USADepartment of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USADepartment of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USADepartment of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USADepartment of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USADepartment of Psychiatry Perelman School of Medicine University of Pennsylvania Philadelphia Pennsylvania USADivision of Emergency Medicine Ann & Robert H Lurie Children's Hospital of Chicago Chicago Illinois USADivision of Emergency Medicine Ann & Robert H Lurie Children's Hospital of Chicago Chicago Illinois USADepartment of Pediatrics Dell Medical School The University of Texas at Austin Austin Texas USADepartment of Emergency Medicine Massachusetts General Hospital Boston Massachusetts USAAbstract Objectives Pediatric readiness varies widely among emergency departments (EDs). The presence of a pediatric emergency care coordinator (PECC) has been associated with improved pediatric readiness and decreased mortality, but adoption of PECCs has been limited. Our objective was to understand factors associated with PECC implementation in general EDs. Methods We conducted semistructured qualitative interviews with a purposively sampled set of EDs with and without PECCs. Interviews were completed, transcribed, and coded until thematic saturation was reached. Themes were identified through a consensus process and mapped to the Consolidated Framework for Implementation Research (CFIR). Results Twenty‐four interviews were conducted and mapped to themes related to innovation, individuals and implementation process, outer setting (health system), and inner setting (hospital/ED). Addressing innovation, individuals, and implementation process, the primary theme was variability in how the PECC role was defined and who was responsible for implementing it. Regarding the outer setting, participants reported that limited system resources affected their ability to implement the PECC role. Key inner setting themes included concerns about limited visit volume, a lack of systems for measuring pediatric quality of care, and significant tension around change. Conclusions Implementation of the PECC role appears to be limited by heterogeneous interpretations of the PECC, de‐prioritization of pediatrics, and limited system resources. However, many participants described motivation to improve pediatric care and implement the PECC role in context of increasing pediatric visits; they offered strategies for future implementation efforts.https://doi.org/10.1002/emp2.13108pediatric emergency carequalityreadiness |
| spellingShingle | Margaret Samuels‐Kalow Krislyn M. Boggs Stephanie S. Loo Maeve F. Swanton William A. Manning Rebecca E. Cash Courtney B. Wolk Elizabeth R. Alpern Kenneth A. Michelson Katherine E. Remick Carlos A. Camargo Jr. “Right now, it's kind of haphazard”—Pediatric emergency care coordinators and quality of emergency care for children: A qualitative study Journal of the American College of Emergency Physicians Open pediatric emergency care quality readiness |
| title | “Right now, it's kind of haphazard”—Pediatric emergency care coordinators and quality of emergency care for children: A qualitative study |
| title_full | “Right now, it's kind of haphazard”—Pediatric emergency care coordinators and quality of emergency care for children: A qualitative study |
| title_fullStr | “Right now, it's kind of haphazard”—Pediatric emergency care coordinators and quality of emergency care for children: A qualitative study |
| title_full_unstemmed | “Right now, it's kind of haphazard”—Pediatric emergency care coordinators and quality of emergency care for children: A qualitative study |
| title_short | “Right now, it's kind of haphazard”—Pediatric emergency care coordinators and quality of emergency care for children: A qualitative study |
| title_sort | right now it s kind of haphazard pediatric emergency care coordinators and quality of emergency care for children a qualitative study |
| topic | pediatric emergency care quality readiness |
| url | https://doi.org/10.1002/emp2.13108 |
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