National Pediatric Readiness Quality Initiative quality measures
| Intervention bundle | Donabedian classification | Phase of care | Quality measures |
| Recognition of a sick or injured child | Process | Assessment | Percentage of paediatric patients with weight documented in kilograms only. |
| Percentage of paediatric patients with pain assessed. | |||
| Percentage of paediatric patients with vital signs re-assessed. | |||
| Intervention | Median time from collection of first set of vital signs to first intervention (eg, oxygen, medication). | ||
| Disposition | ED length of stay (ED arrival to discharge*). | ||
| Timely and effective transfer to appropriate resources | Process | Disposition | Percentage of transferred paediatric patients who met the site-specific criteria for transfers. |
| Time from arrival to transport. | |||
| Percentage of transferred paediatric patients that were discharged from the receiving centre <24 hours of arrival. | |||
| Adherence to evidence-based guidelines† for management of blunt head trauma | Process | Assessment | Percentage of paediatric patients with a full set‡ of vital signs obtained. |
| Percentage of paediatric patients with a Glasgow Coma Scale reassessment. | |||
| Diagnostics | Percentage of patients with a head CT that met one or more PECARN§ criteria. | ||
| Intervention | Percentage of paediatric patients that received hypotonic saline. | ||
| Adherence to evidence-based guidelines for seizures | Process | Assessment | Percentage of paediatric patients with a neurologic reassessment. |
| Intervention | Percentage of paediatric patients that received at least one additional class of antiepileptics (for patients requiring ≥2 doses of benzodiazepines). | ||
| Diagnostics | Percentage of paediatric patients who underwent invasive diagnostic assessments: blood glucose, blood work, urinalysis, lumbar puncture and head CT. | ||
| Adherence to evidence-based guidelines for respiratory reports | Process | Intervention | Percentage of paediatric patients with asthma or croup that received a steroid. |
| Median time to steroids in patients diagnosed with asthma or croup. | |||
| Percentage of paediatric patients ≥2 years with a diagnosis of asthma that received beta agonist. | |||
| Median time to beta agonist administration in patients ≥2 years with a diagnosis of asthma (ED arrival to beta agonist administration). | |||
| Percentage of patients that received an antibiotic. | |||
| Diagnostics | Percentage of patients that underwent a chest X-ray. | ||
| Assess the timeliness and variability of interventions for vomiting | Process | Intervention | Percentage of paediatric patients that received an antiemetic. |
| Time to first antiemetic (ED arrival to antiemetic administration). | |||
| Percentage of patients that received oral rehydration. | |||
| Acute suicidality encounters | Process | Assessment | Percentage of patients who had a structured suicide screen. |
| Percentage of patients with a positive suicide screen who had a structured suicide assessment. | |||
| Intervention | Percentage of patients with a positive suicide screen who had a consultation with a licenced mental health professional. | ||
| Percentage of patients with a positive suicide screen that received a discharge safety plan. |
*For purposes of standardisation, discharge is defined to be the moment of physical departure from the ED.
†Evidence-based guidelines.
‡Includes temperature, heart rate, respiratory rate, blood pressure, pulse oximetry, mental status and pain assessment.
§Paediatric Emergency Care Applied Research Network.
ED, emergency department; PECARN, Paediatric Emergency Care Applied Research Network.