The Implementation of a Pediatric Nonaccidental Trauma Evaluation Protocol: A Quality Improvement Analysis.

Abstract:

BACKGROUND:Pediatric nonaccidental trauma (NAT) accounts for more than 1500 deaths annually and is a source of incalculable lifelong morbidity. Evidence-based NAT evaluation protocols are available; however, compliance studies are lacking. Here, we analyze the quality of implementation of a new NAT evaluation protocol. METHODS:A review of registry data from a level 3 trauma center was performed for patients with a suspicion of NAT from September 2014 to May 2016. Compliance rates and results of 2 new age-based evaluation protocols were examined before (phase 1) and after (phase 2) a multidisciplinary conference was initiated to improve performance. RESULTS:Seventy-five children underwent evaluation for NAT during the study period. In phase 1, median compliance rates with all of the protocol elements were low (63%). After a bimonthly multidisciplinary conference was initiated, compliance rates improved to 75%. Some elements, which were often missed, were found to be clinically irrelevant. If only clinically relevant elements were included, median compliance in phase 2 is 86%. CONCLUSIONS:Compliance with a new protocol for NAT was improved with the institution of a multidisciplinary conference. Protocol elements, which are shown to be clinically unnecessary, have also been identified and will be eliminated.

journal_name

Pediatr Emerg Care

journal_title

Pediatric emergency care

authors

Esquivel A,Pastrana I,Marshall V,Lukefahr JL,Mitchell I

doi

10.1097/PEC.0000000000001981

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

e61-e65

issue

2

eissn

0749-5161

issn

1535-1815

pii

00006565-202002000-00018

journal_volume

36

pub_type

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