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The development of a value-based healthcare burns core set for children after burn injury
Robin A F Verwilligen1, Marscha C Heijblom2, Marjolein van der Vlegel3
1Alliance of Dutch Burn Care (ADBC), Burn Centre, Red Cross Hospital, Beverwijk, the Netherlands; Department of Plastic, Reconstructive & Hand Surgery, Amsterdam UMC location VUmc, Amsterdam, the Netherlands; Amsterdam Movement Sciences, Tissue Function and Regeneration, Amsterdam UMC, Amsterdam, the Netherlands.
Insights
This study developed a core outcome set for pediatric burn care, focusing on patient-relevant outcomes. This set helps improve personalized treatment and patient empowerment in burn aftercare.
Area of Science:
- Pediatric burn care research
- Value-based healthcare (VBHC) implementation
- Patient-reported outcome measures (PROMs)
Background:
- Optimizing person-centered burn care through a value-based healthcare (VBHC) approach.
- Need for a standardized core set of patient-relevant outcomes for VBHC algorithms in burn care.
- Focus on developing a VBHC-burns core set specifically for pediatric patients.
Purpose of the Study:
- To establish a consensus-based core outcome set for pediatric burn care.
- To identify the most important outcomes from the perspective of patients, caregivers, and healthcare professionals.
- To align identified outcomes with existing patient-reported outcome measures (PROMs).
Main Methods:
- Two-round modified Delphi study involving diverse stakeholders.
- Consensus achieved when at least 70% of participants rated an item as important.
- Utilized a 9-point Likert scale in the first round and a yes/no scale in the second round.
Main Results:
- The initial Delphi round identified 10 core outcomes, including physical functioning, quality of life, pain, and mental health.
- The second round added 3 more outcomes: anxiety, self-confidence, and return to school.
- A total of 13 patient-relevant outcomes were established and aligned with PROMs.
Conclusions:
- A comprehensive VBHC burns core outcome set for children has been successfully established.
- The core set is integrated into routine burn aftercare for systematic outcome monitoring.
- Implementation supports personalized care, shared decision-making, and patient empowerment in pediatric burn management.
Background:
This study, involving stakeholders from three Dutch burn centres was conducted to optimize person-centered burn care and improving patient-relevant outcomes, as part of a value-based healthcare (VBHC) approach. Transparent measurement and reporting of patients' relevant outcomes is essential to determine VBHC algorithms, and requires a core set of the most patient-relevant outcomes. The aim of this study was to develop a VBHC-burns core set for children.
Methods:
We conducted a two-round modified Delphi study to reach consensus among caregivers of pediatric burn patients (<18 years old), healthcare professionals and researchers to determine the most important outcomes. In each round, items were selected if at least 70% of each group considered an item 'important'. In the first round a 9-point Likert scale and in the second round a yes/no scale was used to rate if items are important.
Results:
A total of 62 items were included in the Delphi study and 141 participants (60 caregivers of pediatric patients and 81 professionals) completed the first round. In this round, 10 items were included in the VBHC-burns core set: physical functioning, scar contraction, quality of life, pain, itchiness, sleep quality, mobility of functional areas, mental health, depression and the possibility of executing hobbies. The second and last Delphi round was completed by 68 participants in total and resulted in the addition of 3 items: anxiety, self-confidence, return to school. All outcomes were adapted and aligned with available patient reported outcome measures (PROMs).
Conclusions:
This study established a VBHC burns core outcome set, consisting of a holistic set of outcomes that are important for children with burn injuries. The VBHC burns core outcome set is implemented in our routine burn aftercare program, enabling systematic monitoring and analysis of outcomes that matter to pediatric patients and carers. This supports personalized care, shared decision-making, and patient empowerment.
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