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

Infographic · Sep 2025 · 1 min read

In brief

Expert panel used modified Delphi methodology to establish 52 pediatric-specific trauma quality indicators across outcome, process, and structure domains. The consensus-driven framework addresses unique pediatric treatment pathways, care timeliness, injury prevention, and long-term outcomes to guide national quality improvement initiatives.

Expert panel identified 52 pediatric-specific trauma quality indicators using modified Delphi consensus methodology.
Indicators include 25 outcome, 21 process, and 6 structure measures spanning prevention, treatment timeliness, and long-term outcomes.
20 novel indicators address unique pediatric trauma pathways not captured in existing adult-derived quality metrics.
Consensus framework provides foundation for standardized benchmarking across pediatric trauma centers nationally.

Written by the GCMD Library team from the infographic.

A three-column comparison layout with medical illustrations of esophageal procedures. Each column contains anatomical diagrams in blue and pink tones showing the esophagus and stomach, with accompanying text boxes below describing outcomes. The left column shows balloon dilation, the middle shows Heller myotomy, and the right shows POEM procedure. Success rates are prominently displayed with percentage values.

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