582 - Implementation Determinants of Pediatric Readiness in Community Emergency Departments: A CFIR-Guided Evaluation of a Pediatric Emergency Care Coordinator Mentorship Model

Publication Number: 1559.582

Elizabeth Sanseau, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Cage Cochran, Yale-New Haven Children's Hospital, New Haven, CT, United States; Erin Montgomery, Riley Hospital for Children at Indiana University Health, INDIANAPOLIS, IN, United States; Cynthia Mollen, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Benjamin Michaels, Improving Pediatric Acute Care Through Simulation, Guilderland, NY, United States; Marc Auerbach, Yale School of Medicine, New Haven, CT, United States

Background: Most children in the U.S. receive emergency care in community emergency departments (CEDs), which often have low pediatric volumes and variable readiness. Pediatric Emergency Care Coordinators (PECCs) improve readiness, but implementation challenges persist. The Improving Pediatric Acute Care Through Simulation (ImPACTS) program pairs mentors with local PECCs to enhance readiness through simulation, structured debriefing, quality improvement, and longitudinal support. A mentor is a trusted, experienced individual who provides guidance and support to a less experienced person, called a mentee, to help them develop their skills and achieve their goals

Objective: To identify determinants influencing pediatric readiness in CEDs and inform scalable mentorship strategies.

Design/Methods: This qualitative study used semi-structured interviews with 23 PECC Mentors (11 physicians, 12 nurses) from Academic Medical Centers that engaged in the ImPACTS program. Interviews were guided by the Consolidated Framework for Implementation Research (CFIR) and analyzed using deductive coding with inductive thematic refinement. Themes were identified across CFIR domains: intervention characteristics, outer setting, inner setting, individual characteristics, and process.

Results: Mentors highlighted adaptability, dual clinical-mentor roles, and structured tools as critical facilitators (Intervention Characteristics). Peer networks and national resources supported knowledge sharing and reduced isolation (Outer Setting). Institutional support, including leadership engagement and protected time, enhanced implementation (Inner Setting). Persistent barriers included limited administrative time, competing priorities, workforce constraints, and variable awareness of the PECC role (Inner Setting). Key themes included mentorship and relationship-building (Characteristics of Individuals), leadership engagement (Inner Setting), contextual adaptation (Process), peer networks (Outer Setting), and longitudinal support (Process). Table 1- CFIR Barriers and Facilitators for PECCs. Table 2- Themes from PECCs

Conclusion(s): Structured, context-sensitive mentorship programs enable PECCs to enhance pediatric readiness in diverse CEDs. Facilitators include mentorship, peer networks, institutional support, and standardized tools, while barriers center on workforce and resource limitations. CFIR-guided evaluation informs scalable strategies to sustain readiness initiatives, particularly in low-resource and rural settings. Future research should assess impacts on readiness scores, patient outcomes, and health equity.

Themes
themes.pdf

Barriers and Facilitators
tablebarriers.pdf