Policy Development to Improve the Safety of Pediatric Transport During a Disaster

Abstract

Problem: Children transported by a specialized pediatric critical care transport team, staffed with individuals with pediatric training, have better clinical outcomes and are less likely to deteriorate during transport. A group of national stakeholders involved in disaster response identified deficiencies in the transport of critically injured children following a declared disaster. In the setting of disaster, most children are transported by generalist teams who lack specialized training in pediatric care and transport. Purpose: The purpose of this quality improvement policy project was to identify possible policy solutions for the safe and effective transport of children during a disaster. Methods: The initiative utilized the Centers for Disease Control and Prevention Policy Process to draft a policy to address the purpose of the safe and effective transport of children during a disaster. An environmental scan was conducted with eleven national experts in pediatric critical care transport, using the Centers for Disease Control and Prevention Policy Analysis: Key Questions tool, to inform the following possible policy options to: (1) continue with current practice, (2) modify an existing transport policy, or (3) create an entirely new transport policy. Each option was analyzed to determine feasibility, health, and economic/budgetary impact. Results: Results demonstrated high stakeholder buy-in and willingness to participate in a policy development process. Stakeholders unanimously reported an absence of policy related to pediatric transport following a disaster with a substantial gap in research evidence and identified added value for policy development. Conclusions: Modifying an existing policy for pediatric critical care transport would be the most feasible, with the best economic impact and health benefit. A policy solution is expected to add value and create equitable and timely access to appropriate healthcare to improve outcomes.