The Implementation of a Pediatric Nonaccidental Trauma Evaluation Protocol: A Quality Improvement Analysis

Area of Science:

• Medical research
• Pediatric trauma care
• Clinical protocol implementation

Background:

• Pediatric nonaccidental trauma (NAT) causes over 1500 deaths annually and significant long-term morbidity.
• Established evidence-based protocols exist for NAT evaluation, but compliance data is scarce.
• This study assesses the implementation quality of a novel NAT evaluation protocol.

Purpose of the Study:

• To evaluate the compliance rates of a new pediatric nonaccidental trauma (NAT) evaluation protocol.
• To determine the impact of a multidisciplinary conference on protocol adherence.
• To identify and refine clinically relevant elements within the NAT evaluation protocol.

Main Methods:

• A retrospective review of registry data from a level 3 trauma center.
• Analysis of compliance with age-based NAT evaluation protocols before and after implementing a multidisciplinary conference.
• Examination of 75 pediatric cases evaluated for NAT between September 2014 and May 2016.

Main Results:

• Initial compliance with all protocol elements was low at 63% (phase 1).
• Following the introduction of a bimonthly multidisciplinary conference, compliance improved to 75% (phase 2).
• Excluding clinically irrelevant elements, compliance in phase 2 reached 86%.

Conclusions:

• Implementing a multidisciplinary conference effectively enhanced compliance with the pediatric nonaccidental trauma (NAT) evaluation protocol.
• The study identified and will remove clinically unnecessary protocol elements, streamlining the evaluation process.
• Improved protocol adherence is vital for accurate diagnosis and management of pediatric nonaccidental trauma.