Better collaboration and more resources are needed to enhance children’s access to optimal emergency care

WASHINGTON, D.C.—The American Academy of Pediatrics (AAP), the American College of Emergency Physicians (ACEP), and the Emergency Nurses Association (ENA) share a strong commitment to constantly improving emergency care for children. The three organizations detail the progress made and recommend further actions to overcome barriers to access in a new joint policy statement, “Access to Optimal Emergency Care for Children,” published in the May 2021 Pediatrics (published online April 21).

“When a child needs emergency care, parents should not have to worry about if a hospital is equipped to help children or if insurance will cover the care,” said Kathleen M. Brown, MD, FAAP, FACEP, an author of the statement. “We know that 20% of the 27 million emergency care patients are under age 18. Yet few can easily get to a specialized pediatric emergency department, which is why it’s important that all emergency departments are prepared to care for ill and injured children.”

The policy statement identifies strategies for improving emergency care for pediatric patients, such as increasing public awareness about available emergency services and educating families about the differences in services available at an urgent care facility compared to the comprehensive capabilities of an emergency department. The authors also recognize important opportunities to better coordinate emergency services for families who may live in an area without uniform access to 9-1-1 services, face language barriers or lack resources for transportation, particularly in rural areas.

“Advances in pediatric emergency medicine are notable and continue to be incorporated into practice every day,” said Mark Rosenberg, DO, MBA, FACEP, president of ACEP. “Still, emergency physicians and care teams should continue the work necessary to encourage the adoption of these joint recommendations. These principles will help standardize and better connect emergency care for all children and take important steps to improve pediatric patient safety.”

In the policy statement, ACEP, AAP and ENA recommend:

• That pediatricians, emergency physicians, emergency nurses, health care systems and their professional organizations work within their communities to improve awareness of available resources and systems of care. The suggestions include expanding after-hours access to medical care, coordinating with urgent care facilities, and providing electronic versions of the emergency information form with health information exchange for easy access.
• Continuing support from federal governmental agencies for future resource development, education, research, and quality outcomes measurement by the Emergency Medical Services for Children program.
• Improving 9-1-1 systems so they are accessible in all areas. This also calls for collaboration and connectivity between schools, childcare facilities, mental health professionals, medical homes, and local emergency management systems.
• Ensuring that emergency departments are prepared to offer optimal pediatric services, including the expansion of training programs to ensure future availability of adequate numbers of pediatric surgical and medical subspecialists necessary to provide specialized pediatric emergency care.
• Ensuring that state and federal governmental agencies, health care systems and professional organizations work with payors to overcome financial barriers to the provision of optimal emergency care for children.

Children are inherently vulnerable and, given the potential lifelong consequences of poorly treated health conditions, access to optimal emergency health care is important.

“We know access to pediatric emergency care is mainly provided in community hospitals. Children make up about 20 percent of the patient population, and it’s challenging hospitals to specifically allocate necessary resources,” said ENA President Ron Kraus, MSN, RN, EMT, CEN, ACNS-BC, TCRN.

“Emergency departments can help close this gap through ongoing assessment and improvement in pediatric readiness scores based on the 2018 joint AAP/ACEP/ENA policy statement. ENA supports and encourages these efforts, as emergency nurses are uniquely positioned to be ‘Peds Ready’ champions in partnership with our physician colleagues.”

About the American Academy of Pediatrics

The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults. Learn more at AAP.org.

About the Emergency Nurses Association

The Emergency Nurses Association is the premier professional nursing association dedicated to defining the future of emergency nursing through advocacy, education, research, innovation, and leadership. Founded in 1970, ENA has proven to be an indispensable resource to the global emergency nursing community. With more than 50,000 members worldwide, ENA advocates for patient safety, develops industry-leading practice standards and guidelines, and guides emergency healthcare public policy. ENA members have expertise in triage, patient care, disaster preparedness, and all aspects of emergency care. Additional information is available at www.ena.org.