{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T21:53:59Z","timestamp":1792533239097,"version":"4.5.0"},"reference-count":71,"publisher":"American Medical Association (AMA)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Pediatr"],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"\n Importance<\/jats:title>\n Despite the unique physiological characteristics and health care needs of pediatric trauma patients, there is a lack of quality indicators (QIs) based on pediatric-specific evidence to support quality improvement in this population.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To develop a consensus-based set of QIs for acute pediatric trauma care that considers evidence on effectiveness, safety, cost-effectiveness, equity, and caregiver perspectives and is applicable in pediatric and nonpediatric trauma centers.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n A modified Research and Development (RAND)\/University of California Los Angeles (UCLA) expert consensus study was conducted consisting of an online survey and a virtual workshop, led by an independent moderator. Panelists represented key areas of pediatric trauma patient management, diverse care settings (from level I pediatric trauma centers to level III referring centers), 5 high-resource countries, and caregivers. Data were analyzed from May to August 2024.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Likert-scale ratings of 41 QIs.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Panelists rated 41 QIs on a 7-point Likert scale according to 4 criteria: importance, supporting evidence, actionability, and measurability. QIs with a global score of 24 of 28 or greater and an importance score of 6 of 7 or greater were considered accepted by consensus.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 65 experts were invited, of whom 59 accepted (91%; 25 over 50 years of age [44.7%]; 34 female [60.7%]), 56 (95%) completed the first round, and 54 (92%) completed both rounds. Twenty-three QIs were selected covering key areas of acute pediatric trauma management (eg, transfer to a pediatric trauma center for neurotrauma or major multisystem trauma, documentation of vital signs, early rehabilitation, nutritional support), the most common types of injuries (eg, hypertonic saline in severe traumatic brain injury, stabilization of femoral shaft fractures, nonoperative management of solid organ injuries), value in care (eg, imaging in children at low risk on a clinical decision rule), patient-centered care (eg, designated support person, caregiver presence), and equity (eg, mental health screening).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n These results may be used by trauma quality improvement programs in high-resource countries to select context-specific quality indicators to improve the effectiveness, safety, cost-effectiveness, equity, and patient-centered nature of pediatric trauma care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamapediatrics.2025.0036","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T12:00:53Z","timestamp":1743422453000},"page":"666","source":"Crossref","is-referenced-by-count":12,"title":["Evidence-Informed Quality Indicators for Pediatric Trauma Care"],"prefix":"10.1001","volume":"179","author":[{"given":"Lynne","family":"Moore","sequence":"first","affiliation":[{"name":"Population Health and Optimal Health Practices Research Unit, Trauma\u2013Emergency\u2013Critical Care Medicine, Centre de Recherche du CHU de Qu\u00e9bec\u2014Universit\u00e9 Laval (H\u00f4pital de l\u2019Enfant-J\u00e9sus), Qu\u00e9bec, Qu\u00e9bec, Canada"},{"name":"Department of Social and Preventative Medicine, Universit\u00e9 Laval, Qu\u00e9bec, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie L.","family":"Yanchar","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of 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World Society of Emergency Surgery guidelines. Accessed August 15, 2024. https:\/\/wjes.biomedcentral.com\/wses"},{"key":"poi250003r42","unstructured":"American Academy of Pediatrics. Clinical practice guidelines. Accessed August 15, 2024. https:\/\/publications.aap.org\/collection\/523\/Clinical-Practice-Guidelines?autologincheck=redirected"},{"key":"poi250003r51","unstructured":"Pediatric Emergency Care Applied Research Network. PECARN home page. Accessed November 12, 2024. https:\/\/pecarn.org\/"},{"key":"poi250003r52","unstructured":"Pediatric Trauma Society. Welcome to the Pediatric Trauma Society. Accessed November 12, 2024. https:\/\/pediatrictraumasociety.org\/"},{"key":"poi250003r53","unstructured":"PERN-Global. Welcome to the Pediatric Emergency Research Networks (PERN) website. Accessed November 12, 2024. https:\/\/www.pern-global.com\/"},{"key":"poi250003r54","unstructured":"Australian & New Zealand Trauma Society. Australia & New Zealand\u2019s only Multidisciplinary Trauma Society. Accessed November 12, 2024. https:\/\/www.anzts.com.au\/"},{"key":"poi250003r55","unstructured":"Trauma Care. The personal approach to rehabilitation. Accessed November 12, 2024. https:\/\/traumacare.co.uk\/"},{"key":"poi250003r56","unstructured":"American Academy of Pediatrics. COIVPP leadership. Accessed November 12, 2024. https:\/\/www.aap.org\/en\/community\/aap-councils\/Injury-Violence-Poison-Prevention\/about\/coivpp-leadership\/?srsltid=AfmBOord2gpmUUJdD1I9cM3bfBAzkxrF03i82eFd4-JvKPPbjPj9Gay3"},{"key":"poi250003r57","unstructured":"American Congress of Rehabilitation Medicine. Home page. Accessed November 12, 2024. https:\/\/acrm.org\/"},{"key":"poi250003r58","unstructured":"International Initiative for Traumatic Brain Injury Research. InTBIR home page. Accessed November 12, 2024. https:\/\/intbir.incf.org"},{"key":"poi250003r59","unstructured":"North American Brain Injury Association. 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