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

Video Published 2025-09-23

Timestops (6)

00:00:00
Hospital Quality Care
Discussing the need to measure quality care in pediatric trauma centers
00:00:14
Adult Trauma Guidelines
Many guidelines are adapted from adult care, but kids require a different approach
00:00:27
Delphi Process
A structured method used by top pediatric experts to debate and refine quality indicators
00:00:42
Pediatric-Specific Quality Indicators
Results include 52 new quality indicators for outcomes, timeliness, injury prevention, and recovery
00:00:59
Roadmap for Children
A brand new roadmap designed specifically for children's trauma care
00:01:14
Measurement and Improvement
Hospitals can use this roadmap to measure and improve trauma care for kids

Topic Overview

Bailey K. Roberts ∙ Brendan T. Campbell ∙ Aaron R. Jensen ∙ Mauricio A. Escobar ∙ Regan F. Williams ∙ Avery Nathensf∙ 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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