دورية أكاديمية
أعرض في EDS

Establishing national stakeholder priorities for quality improvement in pediatric trauma care: Consensus results using a modified Delphi process.

التفاصيل البيبلوغرافية
العنوان: Establishing national stakeholder priorities for quality improvement in pediatric trauma care: Consensus results using a modified Delphi process.
المؤلفون: Melhado CG; From the Division of Pediatric Surgery (C.G. Melhado, A.R.J.), UCSF Benioff Children's Hospital Oakland, Oakland, California; Department of Surgery (C.G. Melhado, A.R.J.), University of California San Francisco, San Francisco, California; Department of Surgery (B.K.Y.), University of Florida College of Medicine-Jacksonville, Jacksonville, Florida; American College of Surgeons Committee on Trauma (B.P.), Chicago, Illinois; Department of Pediatrics (K.R.), Dell Medical School at the University of Texas at Austin, Austin, Texas; Department of Surgery and Perioperative Medicine (K.R.), Dell Medical School at the University of Texas at Austin, Austin, Texas; Division of Pediatric Emergency Medicine (C.G. Macias), University Hospitals Rainbow Babies and Children's Hospital, Cleveland, Ohio; College of Medicine (C.G. Macias, M.W.D.), Case Western Reserve University, Cleveland, Ohio; Division of Pediatric Surgery (M.W.D.), Rainbow Babies and Children's Hospital, Cleveland, Ohio; and Emergency Medical Services for Children Innovation and Improvement Center (L.G.), University of Texas at Austin, Austin, Texas., Yorkgitis BK, Patel B, Remick K, Macias CG, Dingeldein MW, Gray L, Jensen AR
المصدر: The journal of trauma and acute care surgery [J Trauma Acute Care Surg] 2022 Oct 01; Vol. 93 (4), pp. 467-473. Date of Electronic Publication: 2022 Jun 17.
نوع المنشور: Journal Article; Research Support, U.S. Gov't, P.H.S.
اللغة: English
بيانات الدورية: Publisher: Lippincott, Williams & Wilkins Country of Publication: United States NLM ID: 101570622 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2163-0763 (Electronic) Linking ISSN: 21630755 NLM ISO Abbreviation: J Trauma Acute Care Surg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hagerstown, MD : Lippincott, Williams & Wilkins
مواضيع طبية MeSH: Emergency Medical Services* , Quality Improvement*, Child ; Consensus ; Delphi Technique ; Humans ; Triage
مستخلص: Background: Quality improvement efforts within pediatric trauma centers (PTCs) are robust, but the majority of children do not receive initial postinjury care at PTCs. Disparities in access to quality trauma care remain, particularly for children who initially access the trauma system outside of a PTC. The purpose of this project was to identify unmet needs for injured children within the pediatric emergency care system and to determine national priorities for quality improvement across the continuum of pediatric trauma care.
Methods: A panel of delegates representing patients and families, prehospital providers, federal funding partners, nurses, and physicians was recruited from 10 national stakeholder organizations. Potential targets were identified using an initial stakeholder meeting followed by a free text response survey. Free text items were coded and condensed as themes and then ranked by the panel using a modified Delphi approach to determine consensus priorities. Items not achieving >35% prioritization on a given iteration were dropped from subsequent iterations. Consensus was defined as 75% of members designating an item as a top-four priority.
Results: Nineteen themes were identified as potential targets for QI initiatives. Four iterations of panel ranking were used to achieve consensus, with four priorities identified: (1) creation of a toolkit and standard provider training for pediatric trauma triage, shock recognition, and early recognition for need to transfer to higher level of care; (2) development of minimum standards for pediatric trauma resuscitation and stabilization capability in nonpediatric centers; (3) facilitating creation of local nursing and physician champions for pediatric trauma; and (4) development and dissemination of best-practice guidelines to improve imaging practices for injured children.
Conclusion: System-level quality improvement priorities for pediatric trauma care should focus resources on developing and implementing minimum pediatric standards for injury care, frontline provider training, stabilization protocols, imaging guidelines, and local pediatric champions.
Level of Evidence: Therapeutic/Care Management; Level IV.
(Copyright © 2022 Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a “work of the United States Government” for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government.)
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تواريخ الأحداث: Date Created: 20220617 Date Completed: 20220923 Latest Revision: 20221101
رمز التحديث: 20221213
DOI: 10.1097/TA.0000000000003731
PMID: 35713930
قاعدة البيانات: MEDLINE
الوصف
تدمد:2163-0763
DOI:10.1097/TA.0000000000003731