University Hospitals Rainbow Babies and Children’s Hospital

Pediatric Disaster Care Centers of Excellence Cooperative Agreement

This cooperative agreement establishes the Eastern Great Lakes Pediatric Consortium for Disaster Response (EGLPCDR) as a Center of Excellence (COE). University Hospitals (UH) Rainbow Babies and Children’s Hospital is leading the consortium, along with five children’s hospitals within the states of Michigan and Ohio, to provide expertise with an integrated leadership role within their existing regional emergency preparedness systems.

This consortium will bring together private and public entities, including Regional Healthcare Coalitions (RHCs), emergency medical services (EMS), EMS for Children (EMSC), public health and emergency managers, to provide a multi-pronged approach to address gaps in the disaster cycle spectrum of mitigation, preparedness, response and recovery for nearly 7 million children.

Each entity in EGLPCDR provides unique local and state level expertise, including telemedicine, evidence based clinical guidelines, simulation education, drill scenario expertise, and special care units. These entities will have integrated leadership roles within their RHCs, which include eight coalitions in Michigan and seven coalitions in Ohio.

The overall goal of the EGLPCDR is to harness and develop best-practices around disaster preparedness and response to be shared with other children’s and non-children’s hospitals as well as affiliated entities in the region.

Priorities and Approach

The methods of achieving this objective will focus on three efforts: individual hospital preparedness, regional capacity expansion for pediatric care, and strategic alignment of regional healthcare systems integrated state-level situational awareness tools.

1. Individual hospital preparedness: For each of the children’s hospitals, a capability assessment of specialized bed capacity will be done and non-children’s hospital pediatric capacity has been determined. A tiered system for non-children’s hospitals has been developed for pediatric surge response to expand pediatric capability. Education will further expand pediatric capability and incorporate best practices around simulation, telemedicine, on-line and hands on training sessions in conjunction with national resources (custom regional tailoring) from the disaster domain on the EMS for Children Innovation and Improvement Center (EIIC) website. The EIIC has developed and trained providers, hospitals, and other stakeholders across the EMSC continuum on disaster preparedness and recovery.

2. Regional pediatric capacity expansion will be accomplished through the implementation of the pediatric annexes. Innovative programs such as telemedicine, just-in-time training systems and regional pediatric strike teams will be added to the repertoire of resources to expand capability and capacity. COE subject matter experts (SMEs) will enhance current regional exercises to ensure that pediatric-specific metrics are included to inform state level situational awareness.

3. Strategic alignment of systems and programs, including model integration of state/regional hospital bed status and patient tracking systems specific to pediatrics, will be completed as part of this project. The COE will conduct a review of policies and rules to identify barriers and enablers for mutual aid in disasters within the region.

Existing Collaborations

The co-investigators and personnel have collaborated on previous work in pediatric disaster preparedness and activities of EMSC to improve care for children and families in disasters. Also, the individual SMEs have a history of working with state partners to improve disaster care for children within their respective states; both states and respective SMEs were recipients of American Academy of Pediatrics (AAP)/Center for Disease Control and Prevention grants and conducted virtual disaster exercises statewide. The EIIC, which has matrixed program management with the AAP, the National Association of State EMS Officials, the American College of Emergency Physicians, and the Emergency Nurses Association has assets for dissemination and quality improvement that have been a resource for disaster preparedness and recovery, trauma, prehospital systems, hospitals, healthcare providers and the emergency care space to improve processes and outcomes in the care of children.