The consulting associates of PRG have decades of experience in pediatric emergency medicine and hospital medicine in settings from large academic pediatric EDs to community hospital EDs with general and pediatric emergency physicians working together.
We all continue to practice as pediatric emergency medicine physicians and pediatric hospitalists and lead the hospital administratively to improve the quality, safety, and efficiency of our departments.
In our consulting work, we emphasize the need for best practice while also balancing the feasibility of the interventions and unique challenges of your emergency department and hospital.
Our approach is to fully evaluate the people, systems, and setting of pediatric care by an assessment & optimization of the following high-level areas:
- People: Leadership, teamwork, communication, and the integration of different professional cultures within the emergency department as it pertains to pediatric care
- Systems: Policies, standard operating procedures, evidence-based protocols, clinical decision support systems, and equipment
- Setting: Layout of the physical space and ED environment for pediatric patients and their families
Potential areas for deeper assessment and intervention
- Local EMS policies & procedures for pediatric patient triage and transport
- Community physician’s perception of local/regional pediatric emergency care
- Triage process & standard protocols (Pediatric Assessment Triangle)
- Top ED pediatric diagnoses and evidence-based protocols for them
- Protocols for pediatric trauma & behavioral health
- Evaluation of the equipment/supplies/pharmaceuticals needed for optimal pediatric emergency care
- Examples of some common areas that may need to be addressed to get to best practice pediatric care:
- Procedural sedation, analgesia, and anxiolysis
- Non-traditional therapies before PIV placement
- Child life practices that can be done without a child life specialist, such as distraction and positioning of the patient
- Advanced practice providers (NP/PA) and trainees involvement in pediatric ED care
- ED bedside nursing experience or specialized certification with pediatric care
- ED support services for pediatric care, including social work, care coordination, respiratory care, techs, translation services, radiology, laboratory
- Process for admitted or transferred out patients and the involvement of pediatric hospitalists or other specialists in that care
- Access to pediatric subspecialty care in person or by Telehealth
- Understand the reasons (diagnoses, procedures, etc.…) pediatric patients are transferred out to other hospitals
- Communication process (call, fax, electronic portal) with community primary care providers
- CME/CEU or other educational opportunities for pediatric ED care for the ED staff, including the utilization of simulation-based educational tools or team-based drills