The patients most hospitals are ill-equipped to help

Most hospital emergency departments are not well-prepared to care for critically ill children, leading to preventable deaths and poor patient safety, NPR reported March 3.

Emergency departments receive a weighted Pediatric Readiness Score from the National Pediatric Readiness Project, which assesses whether the department has the equipment, staffing, training policies and patient-safety protocols to care for severely ill and injured children. A 2015 analysis found the median score was a D.

A 2023 study found more than 1,400 children's deaths could have been prevented over a six-year period if every department was prepared for pediatric cases. Children's rate of survival increases four times at emergency departments that are prepared, yet hospitals continue to cut pediatric beds for more lucrative adult care, according to the report. Between 2008 and 2018, hospitals cut nearly 20 percent of pediatric inpatient units, and most pediatric beds are now concentrated in urban areas. 

Although children account for 30 percent of U.S. emergency room visits, most are treated in EDs that care for fewer than 15 kids per day, according to the report. The American Academy of Pediatrics recently released guidelines on improving patient safety for children admitted to the hospital. However, many hospitals transfer kids to children's hospitals to provide more specialized care, and these facilities can get easily overwhelmed by high patient volumes. Some children's hospitals had wait times of hours to days for a bed during the respiratory syncytial virus and influenza surge.

"We were seeing that a patient that might require time-critical interventions was now waiting for those interventions sometimes six, eight, 12 hours in that community [emergency department] setting," Marc Auerbach, MD, professor of pediatrics and emergency medicine at New Haven, Conn.-based Yale School of Medicine, told NPR.

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