# Emergency Medical Services for Children Evaluation of Readiness and Outcomes (EMSC-HERO)

> **NIH AHRQ R01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2022 · $399,864

## Abstract

Emergency Medical Services (EMS) are an essential public resource that operates at the front lines of the
healthcare system for Americans during their most vulnerable times. More than 1.8 million children are
transported to an Emergency Department (ED) by EMS each year in the US, and approximately 90,000 need
immediate intervention and stabilization by EMS providers. However, there are significant deficiencies in the
safety and quality of care. We have found that critical pediatric patients have severe adverse safety events in
23% of calls. Children with respiratory failure requiring endotracheal intubation and children with cardiac arrest,
arguably two of the highest risk and complex medical conditions, experience severe adverse safety events up
to 60% of the time. Rural areas experience even greater challenges to quality pediatric prehospital care. It is
vital for our EMS system to have a high level of readiness for pediatric emergencies, though serious gaps
remain. One major gap is that there is currently no validated means to evaluate EMS agency readiness for
pediatric emergencies. Such a metric would provide vital data on the current status of our system while
empowering leaders and policymakers with information needed to guide resource allocation. Recent studies
have found that hospital-based EDs with the highest readiness scores have more than threefold lower mortality
rates for children with critical illness and trauma than the least ready EDs. Having a pediatric emergency care
coordinator has also emerged as one of the key elements of ED readiness. Recently, the first technical report
on pediatric readiness in EMS was published, which has created a starting point for scientific investigation that
will enhance policymakers' efforts. Our overall goal is to improve the delivery of safe and high-quality
prehospital care for children that maximizes outcomes. This study will expand on the previous methods used to
measure readiness in hospital-based EDs to rigorously evaluate factors that improve pediatric readiness for
EMS agencies and health outcomes for children. We will incorporate a positive deviance framework to ensure
we develop a broad understanding of readiness from the perspective of field providers. The specific health
outcomes we will evaluate include occurrence of adverse safety events during EMS care, as well as hospital
outcomes specific to the diseases we will evaluate. The EMS system is positioned to improve outcomes for
medical conditions that require immediate stabilization, such as seizures, trauma, cardiac arrest, and
respiratory failure, which are our areas of focus. The specific aims of the study are to 1) derive a score that
reflects the readiness of an EMS agency to care for critically ill children using a modified Delphi process among
subject matter experts, 2) evaluate and refine the score developed in Aim 1 using empiric real-world data and
patient outcomes including adverse safety events from both urban and rural ar...

## Key facts

- **NIH application ID:** 10438451
- **Project number:** 1R01HS028429-01A1
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Matthew Lee Hansen
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2022
- **Award amount:** $399,864
- **Award type:** 1
- **Project period:** 2022-07-01 → 2027-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10438451

## Citation

> US National Institutes of Health, RePORTER application 10438451, Emergency Medical Services for Children Evaluation of Readiness and Outcomes (EMSC-HERO) (1R01HS028429-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10438451. Licensed CC0.

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