P3.063: Measuring Pediatric Disaster Readiness of United States Emergency Departments

Background: The state of pediatric disaster readiness of United States emergency departments (EDs) is largely unknown. Study objectives were to evaluate current ED disaster readiness and described identified gaps.

Methods:

Design: Eight domains of disaster readiness were identified utilizing results from the 2021 National Pediatric Readiness Project (NPRP) assessment. An iterative consensus-based approach determined score weighting in each domain. A pediatric weighted disaster readiness score (WDRS) was calculated for all participating hospitals and reported as a median with IQR and by ED pediatric visit volume. Association with higher disaster readiness was assessed using an adjusted WDRS (i.e., normalized to 100 points) calculated excluding points received for presence of a pediatric emergency care coordinator (PECC), quality improvement (QI) plan, emergency physician certification and trauma center (TC) designation.

Results: Of 3647 responses, 3,458 EDs (94.8%) had complete data. (Table 1) The median WDRS was 52.0 [IQR 36.0,75.0] with higher values noted with increasing pediatric visits (P-value < 0.001). The presence of PECCs, a comprehensive QI plan for children, staffing with board certified emergency physicians, and TC designation with both adult and pediatric capabilities were associated with significantly higher WDRS (P < 0.001). Common missing elements in disaster plans include inclusion of pediatric patients in disaster drills, and plans specific to children with behavioral health conditions and special healthcare needs. (Figure 1)

Conclusion: Gaps exist in pediatric disaster planning and efforts to improve pediatric disaster readiness, can begin with ensuring day-to-day pediatric readiness of EDs.