Preparing the State to be "Child Ready"

Robert Sapien, MD, chief of pediatric emergency medicine, is leading a team of researchers to coordinate a sophisticated regionalized care system to improve care for critically sick and injured children across New Mexico.

The Department of Emergency Medicine and the UNM Center for Native American Health are leading a project entitled Child Ready to study and address current gaps in pediatric emergency medical services in rural and tribal communities in New Mexico and border regions of the state.

Critically ill or injured children pose unique challenges to medical responders, and many emergency medical services and facilities lack the specialized equipment and training needed to adequately care for these children.

The project aims to reduce health disparities in emergency pediatric care across the state through rigorous assessment and a research model that engages communities and providers at every level of the project.

Child Ready is funded through a new grant from the Health Resources and Services Administration to support research and implementation of regionalization of emergency medical services for children. Being "Child Ready" means that a critically injured or sick child gets the right care, at the right time, in the right place, regardless of where they live.

"Distance isn't something we can do something about," explains Robert Sapien, MD, chief of Pediatric Emergency Medicine and the principal investigator of Child Ready, "but actual level-of-care is something we should be able to do something about."

For example, by studying transport patterns, the researchers will be able to assist practitioners in rural areas to know when it is best to provide care locally to an injured child—reducing the risks involved in helicopter or ambulance transport and saving families a harrowing car trip across the state to the UNM Pediatric Emergency Department.

"We see our role as facilitating efforts to help identify and address gaps in what communities, local hospitals, and health centers need in order to be child ready and better prepared to provide emergency care to children," explains Sapien.

The project is currently being implemented in Gallup, Acoma/Laguna Pueblos, Clayton, Silver City, and Sandoval County.

As one of six programs chosen nationally for the grant, the UNM site is developing best practices for how to work with tribal and rural populations to assist them in determining themselves whether they are "child ready."

Tassy Parker, PhD, RN, director of the Center for Native American Health and co-investigator, has been instrumental in shaping the community based participatory research components.

A Pediatric Advisory Council, which includes representatives from involved facilities, tribal communities and local stakeholders, meets on a quarterly basis to strengthen community participation and advise the Child Ready team. The project has employed Norman Cooeyate, former governor of the Zuni Tribe and Pueblo Health Officer, as a cultural broker to facilitate alliances and collaborations with rural and tribal communities.

Child Ready is also using advanced communication technologies and in-depth online training modules to deliver a pediatric emergency prevention curriculum.

The Child Ready team is working with the UNM Center for Telehealth and Cybermedicine Research to provide remote access to expert consultation during a pediatric emergency. Infrastructure for bedside telehealth will be implemented in selected clinic sites, and telehealth conferencing will provide training on specific topics.

The research team is systematically evaluating these models of delivery in order to discover the best ways to reach providers in rural and tribal communities. Through assessment and direct action, Child Ready is coordinating a sophisticated regionalized care system to improve care for critically sick and injured children across New Mexico.

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