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Defining and measuring quality in acute paediatric trauma stabilisation: a phenomenographic study.
Ralph James MacKinnon1,2, Karin Pukk-Härenstam1,3, Ulrica Von Thiele Schwarz1,4
11Department of Learning, Informatics, Management and Ethics, Karolinska Institute, Tomtebodavägen 18a, SE-171 65 Solna, Sweden.
Advances in Simulation (London, England)
|April 23, 2019
Summary
Defining high-quality pediatric trauma care is complex. This study developed a framework (System, Team, Process, Individual, Data, Culture) to better evaluate and improve care for critically injured children.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Care Quality Improvement
- Healthcare Systems Analysis
Background:
- Pediatric trauma is a leading cause of death in children.
- Lack of a standardized definition for high-quality pediatric trauma stabilization hinders evaluation of interventions.
- Need for a comprehensive framework to assess and improve initial trauma care.
Purpose of the Study:
- To develop a framework for defining and measuring the quality of pediatric trauma care.
- To explore the perceptions of multidisciplinary teams and administrators regarding trauma care quality.
- To establish a shared understanding of quality in acute pediatric trauma stabilization.
Main Methods:
- Phenomenographic approach used to explore perceptions of quality.
- Interviews conducted with 36 UK trauma team members and governance administrators.
- Data collected from three standard UK trauma units.
Main Results:
- Quality of care is more complex than simple metrics like time to CT scan.
- Quality encompasses a spectrum of perspectives, from basic to sophisticated.
- Key elements of quality include teamwork, individual perspectives, and care culture.
Conclusions:
- A novel framework (System, Team, Process, Individual, Data, Culture) for understanding pediatric trauma care quality has been developed.
- This framework captures multidisciplinary and administrative perspectives on care quality.
- Future tools based on this framework can advance the care of severely injured children.
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