Emergency Preparedness Improvement in Pediatric Primary Care Offices: A Simulation-Based Multicenter Study

BACKGROUND AND OBJECTIVES: Gaps exist in pediatric primary care office preparedness to care for medical emergencies, and providers often express discomfort in caring for these patients. Collaboration with local academic medical centers (AMCs) improved pediatric preparedness in community emergency departments. Our aims were to improve pediatric emergency preparedness and quality of care in a cohort of pediatric primary care offices using a model of in situ simulation and collaboration with local AMCs. METHODS: This was a multicenter, prospective study that measured emergency preparedness and quality of care in a cohort of pediatric primary care offices partnered with multiple AMCs. The study consisted of 3 phases: baseline assessment, an intervention phase, and follow-up assessment. Emergency preparedness was measured using a checklist derived from existing American Academy of Pediatrics guidelines, and quality of care was measured using in situ simulations of common pediatric outpatient emergencies. After baseline assessment, offices were shown their performance and worked with their local AMC on improvement strategies. Repeat assessment was conducted 6 to 10 months later to measure change. RESULTS: Twenty-one offices were recruited, with 18 completing both preparedness assessments and 12 completing both in situ simulations. Median preparedness scores improved from 68% to 82% (P = .02). Median performance scores for the respiratory distress and seizure simulations improved from 50% to 82% (P < .001) and 42% to 85% (P < .001), respectively. CONCLUSIONS: Our collaborative approach improved both emergency preparedness and quality of care in a simulated setting in pediatric primary care offices across multiple AMCs. Future work will focus on expansion and long-term effects of this project.