Evidence-Informed Quality Indicators for Pediatric Trauma Care.

Area of Science:

• Pediatric Trauma Care
• Quality Improvement Science
• Health Services Research

Background:

• Pediatric trauma patients have unique needs, yet lack specific quality indicators (QIs) for improvement.
• Existing quality metrics may not adequately address the complexities of pediatric trauma care.

Purpose of the Study:

• To establish a consensus-based set of QIs for acute pediatric trauma care.
• To ensure QIs are evidence-based, considering effectiveness, safety, cost-effectiveness, equity, and caregiver perspectives.
• To develop QIs applicable across diverse trauma center settings.

Main Methods:

• A modified RAND/UCLA expert consensus study involving surveys and a virtual workshop.
• Inclusion of diverse panelists: pediatric trauma experts, various care settings, international representation, and caregivers.
• Analysis of 41 potential QIs rated on importance, evidence, actionability, and measurability.

Main Results:

• Fifty-nine experts participated, with 54 completing the consensus process.
• Twenty-three QIs were selected, covering neurotrauma, vital signs, rehabilitation, nutrition, specific injuries (TBI, fractures, solid organ), imaging, patient-centered care, and equity.
• Selected QIs focus on areas like transfer protocols, documentation, early interventions, and patient/caregiver support.

Conclusions:

• The developed QIs provide a foundation for quality improvement in pediatric trauma care.
• These indicators can enhance the effectiveness, safety, cost-effectiveness, and equity of care for injured children.
• The consensus-based approach ensures relevance and applicability in various high-resource trauma settings.