High pediatric readiness is associated with decreased mortality. Pediatric emergency care coordinators (PECCs) are associated with improved pediatric readiness. The presence of PECCs in emergency departments (EDs) after COVID is unknown. Our objectives were 1) to describe and analyze the PECC status in 2021 compared to 2013, and 2) to describe the association of change in PECC status with pediatric readiness scores.

We performed a retrospective cohort study comparing the 2013 and 2021 National Pediatric Readiness Project (NPRP) assessments. PECC status was defined as: retained, lost, gained or never based on the presence of either a nurse or physician PECC in 2021 compared to 2013. Hospital and ED characteristics were assessed by PECC status using multivariable logistic analysis. Main outcomes include the association of PECC change on adjusted Weighted Pediatric Readiness Score (aWPRS) and NPRP domain scores analyzed using Kruskal-Wallis. We calculated the aWPRS by removing points associated with a PECC (up to 19) from the overall Weighted Pediatric Readiness Score (WPRS) and normalizing to a total of 100 points.

There were 2825 EDs that completed both assessments. General EDs were more likely to have lost a PECC compared to other ED types (P < 0.001). The loss of a PECC was associated with a 7-point lower overall aWPRS and a statistically significant lower score in all pediatric readiness domains (P < 0.001) compared to EDs that retained or gained a PECC.

Hospitals that lost a PECC in 2021 compared to 2013 had a lower overall aWPRS and in individual domains, suggesting the importance of a PECC in pediatric readiness initiatives.