A Modified Delphi Study to Build Consensus on Pediatric-Specific Trauma Quality Indicators

Infographic · Sep 2025 · 1 min read

In brief

Expert panel used modified Delphi methodology to establish 52 consensus-based quality indicators for pediatric trauma care, including 25 outcome, 21 process, and 6 structure measures. The indicators address pediatric-specific treatment pathways, timeliness of care, injury prevention screening, and long-term outcomes to support benchmarking across trauma centers.

Expert panel identified 52 pediatric-specific trauma quality indicators using modified Delphi consensus methodology across 6 quality domains.
New indicators address unique pediatric needs: age-appropriate treatment pathways, injury prevention screening, and long-term outcomes.
Only 22 of 52 indicators came unchanged from pTQIP; 20 are entirely new, highlighting gaps in current pediatric trauma quality measurement.
Indicators span outcome (25), process (21), and structure (6) measures to enable comprehensive pediatric trauma center benchmarking.
Consensus framework provides foundation for expanding ACS Pediatric Trauma Quality Improvement Program beyond existing adult-derived metrics.

Written by the GCMD Library team from the infographic.

The infographic uses a teal and yellow color scheme with cartoon-style illustrations. The top section shows a clipboard icon and three illustrated panelists at podiums. The middle section displays a group meeting illustration with four people around a table. The layout flows from methodology at top, through results in the middle, to conclusion at bottom.

Bailey K. Roberts ∙ Brendan T. Campbell ∙ Aaron R. Jensen ∙ Mauricio A. Escobar ∙ Regan F. Williams ∙ Avery Nathens ∙ Randall S. Burd ∙ Christian J. Streck ∙ Richard Falcone ∙ Robert W. Letton ∙ R. Todd Maxson ∙ Mark Miller ∙ Benson S. Hsu ∙ Gregory W. Albert ∙ Elizabeth Renaud ∙ Nilda Garcia ∙ Julia Holmes ∙ Christopher Hoeft ∙ Chethan Sathya

Background

Quality improvement efforts across pediatric trauma centers have expanded recently in large part because of the American College of Surgeons Pediatric Trauma Quality Improvement Program. However, consensus on quality indicators (QI) specific to pediatric trauma that measure “quality of care” in this population is lacking. This study aims to identify pediatric-specific trauma QI.

Study design

An expert panel of pediatric trauma leaders was convened. The panel met virtually to define and refine potential QI using a modified Delphi method, prioritizing indicators to include representing important QI for pediatric trauma. A comprehensive list of defined QI was created to improve the quality of pediatric trauma care.

Results

14 experts were included in the panel. After 3 rounds of anonymous voting and meetings, 52 QI were chosen, including 25 outcome, 21 process, and 6 structure variables and spanning 6 domains of quality as defined by the Agency for Healthcare Research and Quality. Indicators comprised 22 unchanged from pTQIP, 10 adapted from currently reported in pTQIP, and 20 new. Indicators encompassed unique treatment pathways for pediatric patients, timeliness of care, screening and prevention of future injuries, and long-term outcomes.

Conclusion

A modified Delphi method was used to develop a novel list of pediatric trauma QI to inform quality improvement and benchmarking efforts for pediatric trauma care. Analysis of outcomes is required to understand the accuracy and usefulness of these newly proposed and existing indicators. This study serves as a starting point for the incorporation of new QI within national quality improvement initiatives.

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