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A Quality Initiative to Decrease Time Until Analgesic for Fracture-associated Pain in the Pediatric Emergency

Justin Davis1, Kristin Kappler2, Skye Stoker2

  • 1Pediatric Emergency Medicine, University of Mississippi Medical Center, Jackson, Miss.

Pediatric Quality & Safety
|September 30, 2021
PubMed

Insights

Implementing four key initiatives significantly reduced the median time to administer pain medication for pediatric long bone fractures. This improvement ensures faster pain relief for children in the emergency department.

Area of Science:

  • Pediatric Emergency Medicine
  • Pain Management
  • Quality Improvement

Background:

  • Long bone fractures are a frequent cause of severe pain in pediatric emergency departments.
  • Timely administration of analgesics is critical for effective pain management in children.

Purpose of the Study:

  • To decrease the median time to the first analgesic dose for long bone fracture pain in a pediatric emergency department to 36 minutes or less.
  • To implement and evaluate a series of quality improvement initiatives.

Main Methods:

  • Four initiatives were implemented using "plan, do, study, act" cycles.
  • Interventions included staff education on triage, in-room triage, quality goal communication, and addressing barriers to care.
  • Data on time to analgesic delivery was collected and analyzed.

Main Results:

  • The median time to analgesic delivery decreased from 72 minutes to 33.5 minutes between April and July 2015.
  • Following interventions, the average monthly median time to analgesia was 48.5 minutes, compared to 66.3 minutes in the prior year.
  • These results demonstrate a significant reduction in pain management delays.

Conclusions:

  • A multi-faceted quality improvement approach effectively reduced analgesic delivery times for pediatric long bone fractures.
  • The implemented initiatives successfully improved the timeliness of pain management in the pediatric emergency department.

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