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Pediatric Readiness

National Pediatric Readiness Project

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National Pediatric Readiness Project

The National Pediatric Readiness Project is a national multi-phase quality improvement initiative to ensure all U.S. emergency departments (EDs) have the essential guidelines and resources in place to provide effective emergency care to children. Updated in 2018, the guidelines are based on a joint policy statement found in ,"Pediatric Readiness in the Emergency Department"


A recent study showed that EDs with higher readiness scores demonstrate a 4-fold lower rate of mortality for children with critical illness than those with lower readiness scores; thus, improving pediatric readiness improves outcomes for children and their families.

The project is supported by the American Academy of Pediatrics, the American College of Emergency Physicians, the Emergency Nurses Association, and the Federal Emergency Medical Services (EMS) for Children Program.


2013-14 National Score

The NPRP Assessment is a national assessment to determine progress in pediatric readiness, identify existing gaps, promote quality improvement (QI) efforts, develop national collaboratives to address common and critical gaps, and identify best practices in EDs around the country. It can help ED personnel become better prepared to provide quality care for all patients of all ages by evaluating the QI processes of EDs over time.


In May 2021, ED Nurse managers will receive several postal and email notifications with a link to the web-based assessment. Click on the image below to view a video about the 2021 NPRP Assessment:




The NPRP assessment contains questions for hospital EDs from categories like: infrastructure, resources, personnel, the administration and coordination of care for children, pediatric-specific policies, equipment, and more. Since only one NPRP assessment per ED can be completed, we strongly encourage ED nurse managers to download and print a PDF copy of the NPRP assessment and review it with their ED leadership before submitting their responses online.

ED Nurse managers who complete the NPRP assessment will immediately receive:

  1. A pediatric readiness score for their ED (range from 0 – 100)
  2. The average pediatric readiness score of EDs of similar pediatric volume
  3. The average pediatric readiness score of all participating ED’s to use as a benchmark
  4. A Gap Report specific to their ED to target efforts for pediatric readiness improvement

Data and Scoring

Guidelines from the 2018 joint policy statement, “Pediatric Readiness in the Emergency Department” addressed gaps that were discovered from the results of a previous assessment conducted in 2013-14. These gaps include physician and nurse pediatric care coordination, pediatric disaster planning, interfacility transfer guidelines, weighing and recording weight only in kilograms, and pediatric specific quality improvement processes in the ED.

The 2021 NPRP assessment has been modified to reflect the new guidelines, ensuring an optimal review of EDs against these updated standards. Therefore, a total 1:1 comparison to questions from 2013-14 and 2021 assessments is impossible. For questions that remain the same for both data collection periods, a 1:1 comparison will be analyzed after July 2021.

The total number of points possible for the 2021 NPRP assessment is 100. A score of 100 represents the essential components needed to establish a solid foundation for pediatric readiness, but is in no way inclusive of all the components recommended for pediatric readiness. EDs are encouraged to carefully review the updated guidelines found in “Pediatric Readiness in the Emergency Department” to develop a comprehensive pediatric readiness program.

The determination of assessment questions scoring was completed by a group of clinical experts through a modified Delphi approach. In developing the scoring criteria, the experts were asked to consider results of recently published assessments on pediatric readiness of emergency departments, as well as recommendations from the Institute of Medicine (now called The National Academies of Sciences, Engineering and Medicine) report on the Future of Emergency Care in the United States.




rev. 18-Feb-2021




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