Measuring Quality in Pediatric Emergency Care

Improving the quality of health care requires measurement. Yet for pediatric emergency care (PEC), there is no widely accepted, organized, and comprehensive method of measuring PEC quality. This article discusses measuring quality in PEC, focusing on a measurement framework that includes the Institute of Medicine quality domains and Donabedian structure-process-outcome formulation for quality and disease frequency and severity. Adoption of this framework will allow PEC practitioners and administrators to assess quality of care in a balanced way. The article also addresses sources of data and responsibility for measurement as well as the integration of prehospital and hospital-based measures. The authors conclude that a lead agency, recognized as a single point of contact for stakeholders and the public, could result in consolidated and effective reporting of measures to greatly benefit the quality of emergency care for children.