A Modified Delphi Study to Build Consensus on Pediatric-Specific Trauma Quality Indicators
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Key Takeaways
- Current TQIP quality indicators lack pediatric-specific consensus; expert panel identified need for 52 total indicators (22 kept, 10 modified, 20 new)
- New pediatric trauma QI measures should include TBI-specific protocols, DVT prophylaxis guidelines, and psychosocial screening components
- Modified Delphi consensus method successfully identified gaps in existing trauma quality metrics for children versus adult populations
- Social determinants of health and acute stress screening emerged as priority additions to pediatric trauma quality assessment
- Pediatric trauma centers need standardized, age-appropriate quality indicators beyond adapted adult metrics to optimize outcomes
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What is quality care in pediatric trauma? I'm Jill Steyer, and this is an article you should know about. Quality improvement has, for lack of a better word, improved in recent years at pediatric trauma centers. This is largely thanks to TQWIP, or the Trauma Quality Improvement Program. But what indicators are we using to measure quality care for pediatric patients? Shouldn't there be a consensus among pediatric trauma centers? In 2025, Roberts et al. published a study in the Journal of Pediatric Surgery. That looked at just that. They surveyed expert pediatric trauma leaders to look at possible QI measures using a modified delta method. After their meetings, they discovered 22 indicators currently in Twp that they would keep, 10 that they would modify, and 20 that they would add. These new indicators included things specific to traumatic brain injuries, the use of DVT prophylaxis, screening for social determinants of health and acute stress, and many more. What indicators would you add for your pediatric patients?