Emergency Medicine

Emergency Medicine

Pediatric Readiness Group Scholarship

papers on a desk

Publication spotlight

Weyant, C., Lin, A., Newgard, C. D., Kuppermann, N., Gausche-Hill, M., Remick, K. E., Hewes, H. A., Burd, R. S., Mann, N. C., Ames, S. G., Carr, B. G., Malveau, S., McConnell, K. J., Cook, J. N. B., & Goldhaber-Fiebert, J. D. (2024). Cost-Effectiveness And Health Impact of Increasing Emergency Department Pediatric Readiness In The US. Health Affairs, 43(10), 1370-1378. https://doi.org/10.1377/hlthaff.2023.01489 

Abstract

The quality of emergency department (ED) care for children in the US is highly variable. The National Pediatric Readiness Project aims to improve survival for children receiving emergency services. We conducted a cost-effectiveness analysis of increasing ED pediatric readiness, using a decision-analytic simulation model. Previously published primary analyses of a nationally representative, population-based cohort of children receiving emergency services at 747 EDs in eleven states provided clinical and cost parameters. From a health care sector perspective, we used a 3 percent annual discount rate and quantified lifetime costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios (ICERs). We performed probabilistic, one-way, and subgroup sensitivity analyses. Increasing ED pediatric readiness yields 69,100 QALYs for the eleven-state cohort, costing $9,300 per QALY gained. Achieving high readiness nationally yields 179,000 QALYs at the same ICER (with implementation costs of approximately $260 million). Implementing high ED pediatric readiness for all EDs in the US is highly cost-effective.

Publications through Oct 2025

  1. Newgard, C. D., Lin, A., Olson, L. M., Cook, J. N. B., Gausche-Hill, M., Kuppermann, N., Goldhaber-Fiebert, J. D., Malveau, S., Smith, M., Dai, M., Nathens, A. B., Glass, N. E., Jenkins, P. C., McConnell, K. J., Remick, K. E., Hewes, H., Mann, N. C., & Pediatric Readiness Study, G. (2021). Evaluation of Emergency Department Pediatric Readiness and Outcomes Among US Trauma Centers. JAMA Pediatr, 175(9), 947-956. https://doi.org/10.1001/jamapediatrics.2021.1319
    1. Grant(s): R24HD085927 Value of ED Peds Readiness
  2. Newgard, C. D., Lin, A., Goldhaber-Fiebert, J. D., Marin, J. R., Smith, M., Cook, J. N. B., Mohr, N. M., Zonfrillo, M. R., Puapong, D., Papa, L., Cloutier, R. L., Burd, R. S., & Pediatric Readiness Study, G. (2022). Association of Emergency Department Pediatric Readiness With Mortality to 1 Year Among Injured Children Treated at Trauma Centers. JAMA Surg, 157(4), e217419. https://doi.org/10.1001/jamasurg.2021.7419
    1. Grant(s): NICHD R24HD085927 Value of ED Peds Readiness
  3. Glass, N. E., Salvi, A., Wei, R., Lin, A., Malveau, S., Cook, J. N. B., Mann, N. C., Burd, R. S., Jenkins, P. C., Hansen, M., Mohr, N. M., Stephens, C., Fallat, M. E., Lerner, E. B., Carr, B. G., Wall, S. P., & Newgard, C. D. (2023). Association of Transport Time, Proximity, and Emergency Department Pediatric Readiness With Pediatric Survival at US Trauma Centers. JAMA Surg, 158(10), 1078-1087. https://doi.org/10.1001/jamasurg.2023.3344
    1. Grant(s): NICHD R24HD085927 Value of ED Peds Readiness
  4. Jenkins, P. C., Lin, A., Ames, S. G., Newgard, C. D., Lang, B., Winslow, J. E., Marin, J. R., Cook, J. N. B., Goldhaber-Fiebert, J. D., Papa, L., Zonfrillo, M. R., Hansen, M., Wall, S. P., Malveau, S., Kuppermann, N., & Pediatric Readiness Study, G. (2023). Emergency Department Pediatric Readiness and Disparities in Mortality Based on Race and Ethnicity. JAMA Netw Open, 6(9), e2332160. https://doi.org/10.1001/jamanetworkopen.2023.32160
    1. Grant(s): HRSA H34MC33243 Changes over time; NICHD R24HD085927 Value of ED Peds Readiness
  5. Newgard, C. D., Babcock, S. R., Song, X., Remick, K. E., Gausche-Hill, M., Lin, A., Malveau, S., Mann, N. C., Nathens, A. B., Cook, J. N. B., Jenkins, P. C., Burd, R. S., Hewes, H. A., Glass, N. E., Jensen, A. R., Fallat, M. E., Ames, S. G., Salvi, A., McConnell, K. J.,…Pediatric Readiness Study, G. (2023). Emergency Department Pediatric Readiness Among US Trauma Centers: A Machine Learning Analysis of Components Associated With Survival. Ann Surg, 278(3), e580-e588. https://doi.org/10.1097/SLA.0000000000005741
    1. Grant(s): HRSA H34MC33243 Changes over time;
  6. Newgard, C. D., Lin, A., Malveau, S., Cook, J. N. B., Smith, M., Kuppermann, N., Remick, K. E., Gausche-Hill, M., Goldhaber-Fiebert, J., Burd, R. S., Hewes, H. A., Salvi, A., Xin, H., Ames, S. G., Jenkins, P. C., Marin, J., Hansen, M., Glass, N. E., Nathens, A. B.,…Pediatric Readiness Study, G. (2023). Emergency Department Pediatric Readiness and Short-term and Long-term Mortality Among Children Receiving Emergency Care. JAMA Netw Open, 6(1), e2250941. https://doi.org/10.1001/jamanetworkopen.2022.50941
    1. Grant(s): NICHD R24HD085927 Value of ED Peds Readiness
  7. Newgard, C. D., Malveau, S., Mann, N. C., Hansen, M., Lang, B., Lin, A., Carr, B. G., Berry, C., Buchwalder, K., Lerner, E. B., Hewes, H. A., Kusin, S., Dai, M., Wei, R., & Pediatric Readiness Study, G. (2023). A Geospatial Evaluation of 9-1-1 Ambulance Transports for Children and Emergency Department Pediatric Readiness. Prehosp Emerg Care, 27(2), 252-262. https://doi.org/10.1080/10903127.2022.2064020
    1. Grant(s): HRSA H34MC33243 Changes over time; NICHD R24HD085927 Value of ED Peds Readiness
  8. Newgard, C. D., Smith, M., Lin, A., McConnell, K. J., Remick, K. E., Burd, R. S., Marin, J. R., Mann, N. C., Gausche-Hill, M., Hewes, H. A., Child, A., Lang, B., Foster, A. A., Maughan, B., & Goldhaber-Fiebert, J. D. (2023). The Cost of Emergency Care For Children Across Differing Levels of Emergency Department Pediatric Readiness. Health Affairs Scholar. https://doi.org/10.1093/haschl/qxad015
    1. Grant(s): HRSA H34MC33243 Changes over time; NICHD R24HD085927 Value of ED Peds Readiness
  9. Remick, K., Smith, M., Newgard, C. D., Lin, A., Hewes, H., Jensen, A. R., Glass, N., Ford, R., Ames, S., Cook, J., Malveau, S., Dai, M., Auerbach, M., Jenkins, P., Gausche-Hill, M., Fallat, M., Kuppermann, N., & Mann, N. C. (2023). Impact of individual components of emergency department pediatric readiness on pediatric mortality in US trauma centers. J Trauma Acute Care Surg, 94(3), 417-424. https://doi.org/10.1097/TA.0000000000003779
    1. Grant(s): HRSA H34MC33243 Changes over time; NICHD R24HD085927 Value of ED Peds Readiness
  10. Ames, S. G., Salvi, A., Lin, A., Malveau, S., Mann, N. C., Jenkins, P. C., Hansen, M., Papa, L., Schmitz, S., Sabogal, C., Newgard, C. D., & Pediatric Readiness Study, G. (2024). Timing and causes of death to 1 year among children presenting to emergency departments. Acad Emerg Med, 31(6), 555-563. https://doi.org/10.1111/acem.14875
    1. Grant(s): HRSA H34MC33243 Changes over time; NICHD R24HD085927 Value of ED Peds Readiness
  11. Newgard, C. D., Lin, A., Goldhaber-Fiebert, J. D., Remick, K. E., Gausche-Hill, M., Burd, R. S., Malveau, S., Cook, J. N. B., Jenkins, P. C., Ames, S. G., Mann, N. C., Glass, N. E., Hewes, H. A., Fallat, M., Salvi, A., Carr, B. G., McConnell, K. J., Stephens, C. Q., Ford, R.,…Kuppermann, N. (2024). State and National Estimates of the Cost of Emergency Department Pediatric Readiness and Lives Saved. JAMA Network Open, 7(11), e2442154-e2442154. https://doi.org/10.1001/jamanetworkopen.2024.42154
    1. Grant(s) HRSA H34MC33243 Changes over time; NICHD R24HD085927 Value of ED Peds Readiness
  12. Newgard, C. D., Rakshe, S., Salvi, A., Lin, A., Cook, J. N. B., Gausche-Hill, M., Kuppermann, N., Goldhaber-Fiebert, J. D., Burd, R. S., Malveau, S., Jenkins, P. C., Stephens, C. Q., Glass, N. E., Hewes, H., Mann, N. C., Ames, S. G., Fallat, M., Jensen, A. R., Ford, R. L.,…Remick, K. E. (2024). Changes in Emergency Department Pediatric Readiness and Mortality. JAMA Network Open, 7(7), e2422107-e2422107. https://doi.org/10.1001/jamanetworkopen.2024.22107
    1. Grant(s): HRSA H34MC33243 Changes over time; NICHD R24HD085927 Value of ED Peds Readiness
  13. Remick, K. E., Gausche-Hill, M., Lin, A., Goldhaber-Fiebert, J. D., Lang, B., Foster, A., Burns, B., Jenkins, P. C., Hewes, H. A., Kuppermann, N., McConnell, K. J., Marin, J., Weyant, C., Ford, R., Babcock, S. R., Newgard, C. D., & Pediatric Readiness Study, G. (2024). The hospital costs of high emergency department pediatric readiness. J Am Coll Emerg Physicians Open, 5(3), e13179. https://doi.org/10.1002/emp2.13179
    1. Grant(s) HRSA H34MC33243 Changes over time; NICHD R24HD085927 Value of ED Peds Readiness
  14. Weyant, C., Lin, A., Newgard, C. D., Kuppermann, N., Gausche-Hill, M., Remick, K. E., Hewes, H. A., Burd, R. S., Mann, N. C., Ames, S. G., Carr, B. G., Malveau, S., McConnell, K. J., Cook, J. N. B., & Goldhaber-Fiebert, J. D. (2024). Cost-Effectiveness And Health Impact of Increasing Emergency Department Pediatric Readiness In The US. Health Affairs, 43(10), 1370-1378. https://doi.org/10.1377/hlthaff.2023.01489
    1. Grant(s): HRSA H34MC33243 Changes over time; NICHD R24HD085927 Value of ED Peds Readiness
  15. Newgard, C. D., Babcock, S., Malveau, S., Lin, A., Goldstick, J., Carter, P., Cook, J. N. B., Song, X., Wei, R., Salvi, A., Fallat, M. E., Kuppermann, N., Jenkins, P. C., Fein, J. A., & Mann, N. C. (2025). Firearm Injury Risk Prediction Among Children Transported by 9-1-1 Emergency Medical Services: A Machine Learning Analysis. Pediatr Emerg Care, 41(3), 195-202. https://doi.org/10.1097/PEC.0000000000003314
    1. Grant(s): NICHD R01HD10817 Firearms Inj Prevention
  16. Newgard, C. D., Malveau, S., Lin, A., Carter, P., Goldstick, J., Cook, J. N. B., Mann, N. C., Song, X., Babcock, S. R., Kuppermann, N., Salvi, A., Fallat, M. E., Jenkins, P. C., & Wei, R. (2025). Geospatial Clustering of 9-1-1 Responses for Pediatric Firearm Injuries Over Time. Pediatrics, 155(4). https://doi.org/10.1542/peds.2024-068179
    1. Grant(s): NICHD R01HD10817 Firearms Inj Prevention

Through October 2025

  1. Emergency Department Pediatric Readiness: Lives Saved, Costs, and How to Improve Care
    1. Healthcare Association of New York State. February 24, 2025 (approximately 100 attendees)
  2. National Research Conference for the Prevention of Firearm-Related Harms Abstract, December 2024
    1. Neighborhood Characteristics Associated with Firearm Injuries in Children and Adolescents Across the U.S Presenter Amber Lin
    2. Panel Discussion of Pediatric Firearms Injury Prevention; Presenter: Craig Newgard
  3. Emergency Medical Services for Children State Partnership Town Hall – Results from the HRSA Targeted Issues grant on ED Pediatric Readiness.
    1. EMSC Town Hall. November 13, 2024. National meeting with EMSC representatives from 50 states (approximately 200 attendees).
  4. Data Science and Lives Saved: The Story of Emergency Department Pediatric Readiness.
    1. The Action Collaborative on Disaster Research: Symposium on Disaster Data Science, National Academies of Sciences, Engineering and Medicine (NASEM). April 2, 2024, national meeting with peak viewership at 258 (attendees from NASEM, NIH, federal agencies, academic medical centers, disaster agencies), 1,383 views.
  5. Examples of Using Large Data Sources to Address Emergency Care Research Questions: ED Pediatric Readiness & Firearm Injury Prevention.
    1. Monthly SIREN Scholars meeting (remote), February 7, 2024 (approximately 35 attendees from across the US)
  6. EMSC All Grantee Meeting Poster Session, September 13, 2023 (Austin, TX)
    1. "Emergency Department Pediatric Readiness and Short-term and Long-term Mortality Among Children Receiving Emergency Care," Presenter: Craig Newgard
    2. "Hospital Costs Required to Reach and Maintain High Emergency Department Pediatric Readiness" Presenter, Marianne Gauche-Hill
  7. A Multi-State Evaluation of Emergency Department Pediatric Readiness: Guideline Update and Association with Quality, Outcomes, and Cost.
    1. EMSC-All Grantee Meeting, Research Symposium Presentation, Presenter Craig Newgard, September 13, 2023 (Austin, TX) (Approximately 60 attendees in person)
  8. Preparación Pediátrica de Urgencias (Spanish)
    1. Invited Speaker – Simposio Urgencias Pediátricas Presentes en la niñez mexicana, Hospital Infantil de México Federico Gomez; Mexico City, April 24, 2023; (Approx 600 attendees (70 in-person, 500 online))
  9. Building a Pipeline of and the Capacity for Pediatric Disaster Scientists.
    1. National Academies of Sciences, Engineering, and Medicine – The Action Collaborative on Disaster Research, Symposium on Pediatric Disaster Science; August 2, 2022 (approx. 100 attendees across NIH, CDC, HRSA, other governmental agencies and academic institutions)
  10. Trauma and Medical Preparedness and Response Science for Better Physical Outcomes.
    1. National Academies of Sciences, Engineering, and Medicine – The Action Collaborative on Disaster Research, Symposium on Pediatric Disaster Science; August 1, 2022 (approx. 100 attendees across NIH, CDC, HRSA, other governmental agencies and academic institutions)
  11. Climate and Emergency Care (and Trauma) Systems.
    1. NIH-wide Climate Change and Health Webinar Series, April 8, 2022 (271 attendees across the US, including NIH and the general public)
  12. Emergency Department Pediatric Readiness and Outcomes
    1. HRSA EMSC National Pediatric Readiness Project (NPRP) Steering Committee meeting; February 8, 2022 (approx. 60 attendees)
  13. Improving Survival After Injury Through Emergency Department Pediatric Readiness.
    1. President's Task Force on Environmental Health Risks and Safety Risks to Children. November 18, 2021 (representatives from 18 US Government Agencies)
  14. What to Expect When You're Not Expecting Injured Children: Pediatric Readiness in Adult Trauma Centers (90-minute presentation, five speakers)
    1. American College of Surgeons Committee - Trauma Annual Trauma Quality Improvement Program (TQIP) Annual Conference. November 16, 2021 (2,200 attendees for this presentation)
  15. How To Get Involved In Pediatric Readiness Scholarship and Research – Emergency Department Pediatric Readiness and Outcomes Research (co-presentation with Dr. N. Clay Mann).
    1. American Academy of Pediatrics, Pediatric Readiness Subcommittee, Section of Emergency Medicine. Webinar, September 14, 2021 (150 registrants)
  16. A Multi-State Evaluation of Emergency Department Pediatric Readiness: Guideline Uptake and Association with Quality, Outcomes, and Cost.
    1. Emergency Medical Services for Children All Grantee Meeting "Adapting and Forging New Paths," US. Health Resources & Services Administration, Maternal and Child Health Bureau, August 31, 2021 (65 attendees)
  17. ED Pediatric Readiness and Injured Children: An update and preliminary results from our HRSA and NICHD projects.
    1. Emergency Medical Services for Children Program Quarterly Town Hall, US Health Resources & Services Administration, Maternal and Child Health Bureau, May 12, 2021 (70 attendees)
  18. ED Pediatric Readiness and Injured Children.
    1. Northwest States Trauma Conference, May 6, 2021 (approximately 300 attendees)
  19. EMS Pediatric Readiness and Injured Children.
    1. Northwest States Trauma Conference, May 6, 2021 (approximately 300 attendees)