The IOM’s study of the future of emergency care in the U.S. health system was initiated in September 2003. Support for the study was provided by the Josiah Macy, Jr. Foundation, the National Highway Traffic Safety Administration (NHTSA), AHRQ within the U.S. Department of Health and Human Services (DHHS), the Centers for Disease Control and Prevention (CDC), and the Health Resources and Services Administration (HRSA). The study was designed to build on previous work in the field by bringing together all of the key components of emergency care—prehospital EMS, hospital-based emergency care, trauma care, and injury prevention and control. The committee was charged with assessing the current emergency care system, identifying its strengths and weaknesses, creating a vision for the future system, and making policy recommendations for achieving that vision.
The committee was structured to balance the desire for a highly integrated systems approach to the study with an interest in focusing attention on pediatric, EMS, and hospital-based emergency care issues. The result was a main committee and three subcommittees representing those three focus areas (see Figure 1-3).
The main committee guided the overall study process. The three subcommittees examined the unique challenges associated with the provision of emergency services to children, issues related to prehospital EMS, and issues related to hospital-based emergency and trauma care. The charge to the pediatric subcommittee is shown in Box 1-1. The membership of the main committee and subcommittees overlapped—the 11-member pediatric subcommittee, for example, included 5 members from the main committee. Subcommittees met both separately, reporting their discussions and findings to the main committee, and in combined session with the main committee. Altogether, 40 individuals served on one or more of the four committees.1 See Appendixes A and B, respectively, for a listing of all committee and subcommittee members and for biographical information on members of the main committee and the subcommittee on pediatric emergency care. Three reports covering each of the three subject areas were developed. The present report presents the committee’s findings with regard to pediatric emergency care. The recommendations from all three reports appear in Appendix E.
A total of 17 main committee and subcommittee meetings were held between February 2004 and October 2005. The committee commissioned 11 technical papers (see Appendix D) and heard testimony from a wide