# Components of emergency department pediatric readiness associated with short- and long-term survival among children: a mixed methods evaluation

> **NIH NIH R01** · OREGON HEALTH & SCIENCE UNIVERSITY · 2024 · $630,165

## Abstract

Proposed Approach: We will use a mixed methods study design to identify the components of
emergency department (ED) pediatric readiness most predictive of short- and long-term survival among
children. This project will help EDs prioritize implementation of ED readiness to save pediatric lives. We
will use existing research infrastructure, data science methods, the ability to follow children to one year,
novel analytics, and an interdisciplinary team to address this critical public health need.
Importance: Injury and acute illness are the leading causes of death in children. We have recently
shown that high ED pediatric readiness in US trauma centers and general hospitals is independently
associated with improved survival, but the components of ED readiness driving survival are unknown. It
is also unclear whether other organizational factors or ED processes of care improve survival among
children. Answers to these questions will guide EDs in prioritizing the implementation of ED readiness,
especially in smaller hospitals and rural settings with limited resources and budgets. This project is
designed to inform the national trauma center verification criteria, the national field triage guidelines, the
National Pediatric Readiness Project, and the Emergency Medical Services for Children program.
Objectives: There are three specific aims:
Specific Aim 1: We will build two multi-state cohorts of children receiving emergency care and use machine
learning to identify the components of ED pediatric readiness predictive of short- and long-term survival.
Specific Aim 2. Empirically develop a global measure of ED pediatric readiness and compare it to the weighted
Pediatric Readiness Score for predicting short- and long-term survival in children.
Specific Aim 3: Use a positive deviance approach to identify ED pediatric readiness factors and processes of
care associated with improved survival among children receiving emergency care.
Study Design & Setting: We will build two cohorts of children using emergency services from 1/1/2018 to
12/31/2022 in 928 EDs in 11 states (ED cohort) and 678 trauma centers in 50 states (Trauma cohort). We will
link state vital statistics death records to the cohorts to track outcomes to one year and assess 152 unique
components of ED readiness using machine learning methods. We will also conduct 150 interviews in 30
hospitals across the US using positive deviance methods as a complement to the quantitative analyses.
Participants: Injured children 0–17 years using emergency services, including 15.6 million children with
ED visits, 606,810 hospitalized children, and 264,865 children admitted to US trauma centers.
Outcome measures: We will evaluate in-hospital mortality (primary) and 1-year mortality (secondary)
at the patient-level. We will also evaluate the observed versus expected mortality at the ED-level to
facilitate the positive deviance analysis.

## Key facts

- **NIH application ID:** 10900630
- **Project number:** 5R01HD109134-02
- **Recipient organization:** OREGON HEALTH & SCIENCE UNIVERSITY
- **Principal Investigator:** Craig D. Newgard
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $630,165
- **Award type:** 5
- **Project period:** 2023-08-10 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10900630

## Citation

> US National Institutes of Health, RePORTER application 10900630, Components of emergency department pediatric readiness associated with short- and long-term survival among children: a mixed methods evaluation (5R01HD109134-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10900630. Licensed CC0.

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