# Role of individual and hospital factors in quality of care for children in EDs

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2022 · $423,409

## Abstract

Abstract
Although most children receive emergency care in general emergency departments (EDs), national studies
have shown that pediatric readiness is low and that the lack of readiness has consequences for clinical quality
and outcomes. Presentation to a highly prepared hospital, one with a high pediatric readiness score, is
associated with decreased in-hospital mortality. Presence of a pediatric emergency care coordinator (PECC) is
associated with increased readiness, but limited data are available to directly assess the association between
PECC status and quality of care for children. Previous work has focused primarily on quality variation among
specialty pediatric centers which account for a minority of care provided to pediatric patients and have very
different staffing and resources as compared to general EDs. Our long-term goal is to develop systems to
improve care for children presenting to general EDs. The goal of this R01 project is to define the hospital-level
characteristics associated with quality of care provided to children in general EDs. We will use a slate of
recently developed process and outcome quality measures across geographically diverse states with high-
quality pediatric data available. Our primary hypothesis is that more intensive pediatric-focused staffing (e.g.
more robust PECC implementation) is associated with higher-quality care and better clinical outcomes for
children. The specific aims are to (1) Identify PECC implementation factors that are associated with variation in
quality of emergency care for children (2) Establish if PECC status is associated with higher quality of care for
children treated in general EDs and (3) Determine if disparities in quality of care by race/ethnicity and
insurance vary by PECC status. The proposed work builds on our pilot work with the National ED Inventory
(NEDI-USA) database, as well as on our team’s strong track record in health services research with large
administrative databases and qualitative and implementation expertise. In the proposed work, we fulfill two of
the primary goals of the NICHD Strategic Plan: (1) “improving child and adolescent health” and (2) addressing
“pervasive disparities…improving approaches in populations that experience specific cultural, social, or access
issues.” These data will provide a critical understanding of the association between PECC, workforce factors,
and quality of care for children. This understanding is the prerequisite for developing evidence-based
interventions to improve outcomes for all children receiving emergency care in general EDs.

## Key facts

- **NIH application ID:** 10459549
- **Project number:** 5R01HD103637-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Margaret Emily Samuels-Kalow
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $423,409
- **Award type:** 5
- **Project period:** 2021-08-01 → 2025-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10459549

## Citation

> US National Institutes of Health, RePORTER application 10459549, Role of individual and hospital factors in quality of care for children in EDs (5R01HD103637-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10459549. Licensed CC0.

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