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

Award Number: R01HS028429
ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY
OPDIV: AHRQ
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/01/2022
PERIOD OF PERFORMANCE END DATE: 04/30/2027

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Emergency Medical Services for Children Evaluation of Readiness and Outcomes (EMSC-HERO) - 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 areas, and 3) use qualitative interviews in a positive deviance framework to identify specific agency activities and attributes among the highest and lowest performing EMS agencies, in both urban and rural areas.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $381,447 )
2026	2026	OREGON HEALTH & SCIENCE UNIVERSITY	3181 SW SAM JACKSON PARK RD	PORTLAND	OR	97239	MULTNOMAH	USA	Research on Healthcare Costs, Quality and Outcomes	000	5	4/21/2026	NON-COMPETING CONTINUATION	$381,447
														Subtotal = $381,447

Issue Date FY: 2025 ( Subtotal = $386,067 )
2025	2025	OREGON HEALTH & SCIENCE UNIVERSITY	3181 SW SAM JACKSON PARK RD	PORTLAND	OR	97239	MULTNOMAH	USA	Research on Healthcare Costs, Quality and Outcomes	000	4	6/5/2025	NON-COMPETING CONTINUATION	$386,067
														Subtotal = $386,067

Issue Date FY: 2024 ( Subtotal = $389,577 )
2024	2024	OREGON HEALTH & SCIENCE UNIVERSITY	3181 SW SAM JACKSON PARK RD	PORTLAND	OR	97239	MULTNOMAH	USA	Research on Healthcare Costs, Quality and Outcomes	000	3	4/17/2024	NON-COMPETING CONTINUATION	$389,577
														Subtotal = $389,577

Issue Date FY: 2023 ( Subtotal = $398,785 )
2023	2023	OREGON HEALTH & SCIENCE UNIVERSITY	3181 SW SAM JACKSON PARK RD	PORTLAND	OR	97239	MULTNOMAH	USA	Research on Healthcare Costs, Quality and Outcomes	000	2	4/19/2023	NON-COMPETING CONTINUATION	$398,785
														Subtotal = $398,785

Issue Date FY: 2022 ( Subtotal = $399,864 )
2022	2022	OREGON HEALTH & SCIENCE UNIVERSITY	3181 SW SAM JACKSON PARK RD	PORTLAND	OR	97239	MULTNOMAH	USA	Research on Healthcare Costs, Quality and Outcomes	000	1	6/30/2022	NEW	$399,864
														Subtotal = $399,864

Grand Total All Awards = $1,955,740

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

Award Number: R01HS028429

ORGANIZATION: AGENCY FOR HEALTH CARE RESEARCH AND QUALITY

OPDIV: AHRQ

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/01/2022

PERIOD OF PERFORMANCE END DATE: 04/30/2027

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