HD57 - Pediatric Emergency Medical Service Capabilities of Virginia Hospitals


Executive Summary:
The 1996 General Assembly, through House Joint Resolution 213, charged the Virginia Department of Health (VDH) and the Virginia Hospital and Healthcare Association to study the ability of emergency service hospitals to provide pediatric emergency medical services. To adequately respond to this charge, VDH convened a task force. Under task force guidance, VDH conducted a study which included: a comprehensive resource and capability survey of all Virginia hospitals providing emergency services; entry of survey data into a spreadsheet; analysis of data; and development of conclusions and recommendations.

Analysis of data provided several findings. All Virginia hospitals which provide twenty-four hour emergency services integrated pediatric emergency medical services within their scope of care. All hospital emergency departments had extensive equipment resources essential for emergency care of the pediatric population. The strongest predictor of a hospital having a pediatric emergency department was an affiliation with a pediatric residency program, not the volume of pediatric patient visits or total annual visits.

Analysis of transfer/referral patterns indicated appropriate access to pediatric emergency care in the Commonwealth. Hospitals noted utilization of major pediatric specialty services which are distributed across the state in urban hospitals located in Falls Church, Richmond, Norfolk, Charlottesville, and Roanoke.

It was the conclusion of the task force that pediatric emergency medical services are adequate and available across the state. Pediatric emergency departments are most appropriately located in hospitals with a strong medical education component. Utilization of residents in satellite hospitals affords outlying communities access to a high level of care. In addition, equipment, personnel and staff preparation are adequate for care of the pediatric population. Finally, transfer and referral patterns are adequate and indicate utilization of resources at recognized major pediatric referral centers across the Commonwealth.

The task force recommends that there should be no additional mandates to establish pediatric emergency departments. This recommendation is based on the finding that these dedicated units exist in facilities providing higher medical education, and as such, are distributed across the Commonwealth. The task force further recommends that there should be ongoing support of residency programs which deploy physicians to outlying facilities, thus allowing greater access to a high level of care. Finally, the task force recommends that hospitals invest in a hypothermia thermometer.