Derivation of Pediatric Emergency Preparedness Checklist for Urgent Care Centers

Abstract

OBJECTIVES To develop a consensus-based pediatric emergency preparedness checklist tailored for urgent care centers, addressing policies, procedures, personnel, equipment, and medications necessary to stabilize critically ill or injured children prior to transfer. METHODS A modified Delphi methodology with a purposive sample of 30 nationally recognized physician experts in urgent care medicine, pediatric emergency medicine, or pediatric critical care medicine was conducted. Respondents were recruited using personalized email invitations. The proposed list, derived from urgent care accreditation standards, published pediatric readiness guidelines, and literature review, contained 28 comprehensive items, many of which had multiple subcomponents, totaling 169 individual items. These 28 items spanned across policy/procedures, personnel, equipment, and medications. Consensus was predefined as greater than or equal to 80% agreement for inclusion to the next round. Items receiving less than 80% agreement were removed from the subsequent round. Respondents evaluated these proposed items until consensus saturation was achieved with an opportunity to provide textual feedback in each round. This was achieved after 3 iterative rounds (May 2024 to July 2025). RESULTS Twenty-two of 30 (73%) invited respondents completed all rounds. In round 1, 26 of 28 items achieved consensus; round 2 produced consensus on 22 of 26 items; and round 3 finalized 22 items with 100% consensus. Textual feedback highlighted distinctions between urgent care and emergency departments, deemphasizing items such as advanced airway equipment, an expansive list of nonemergent medications, and disaster preparedness. The final framework included 12 policy/procedure items, 2 personnel items, 7 equipment items, and 1 medication item. CONCLUSION Through expert consensus, a pediatric emergency preparedness checklist for urgent care centers was developed. This tool provides actionable guidance for facilities and policymakers to enhance pediatric readiness while recognizing the resource and scope limitations inherent to urgent care practice. Adoption of this framework can standardize preparedness, which may improve pediatric outcomes when patients present with emergencies to urgent care centers.