Defining Benchmarks in Pediatric Burn Care: Inception of the Pediatric Injury Quality Improvement Collaborative

Abstract

Pediatric burn care is highly variable nationwide. Standardized quality and performance benchmarks are needed for guiding performance improvement within pediatric burn centers. A network of pediatric burn centers was established to develop and evaluate pediatric-specific best practices. A multi-disciplinary team including pediatric surgeons, nurses, advanced practice providers, pediatric intensivists, rehabilitation staff, and child psychologists from five pediatric burn centers established a collaborative to share and compare performance improvement data, evaluate outcomes, and exchange best care practices. In December 2016, the Pediatric Injury Quality Improvement Collaborative (PIQIC) was established. PIQIC members chose quality improvement indicators, drafted and approved a memorandum of understanding (MOU), data use agreement (DUA) and charter, formalized the multidisciplinary membership, and established a steering committee. Since inception, PIQIC has conducted monthly teleconferences and biannual in-person or virtual group meetings. A centralized data repository has been established where data is collated and analyzed for benchmarking in a blinded fashion. PIQIC has shown the feasibility of multi-institutional data collection, implementation of performance improvement metrics, publication of research, and enhancement of aggregate and institution-specific pediatric burn care.

Predictors of Follow-up Compliance in Pediatric Burn Patients During the Time of COVID

“… 11 Due to the psychological, medical, and esthetical implications of burn injuries, these patients require close monitoring by a multidisciplinary team to ensure best outcomes. 19 , 20 A key component to this is attendance of patients to burn clinics following treatment in the ED. However, there have been limited data on the overall outpatient compliance in pediatric burn patients.…”

Quality indicators for hospital burn care: a scoping review

“…Indication of artificial feeding [28,30] 11. Time of psychosocial assessment [2,8,9] 12. Pain assessment on admission and during hospitalisation [2,[33][34][35][36][37][38][39][40][41][42][43] 13.…”

“…Monitoring of resuscitation volume [9,46,48,51] 22. Time from admission to start feeding [2,4,8,9,28,29,52,53] 23. Energy and protein needs [7, 28-30, 32, 54, 55] 24.…”

“…Duration of surgical procedures [16,61,62,[65][66][67][68] 32. Time from admission to first surgical excision [4,8,19] 33. Time to complete eschar removal [2,4,9,20,44,45,67] 34.…”

“…In the literature, it is possible to find studies describing the process and results of developing a list of quality indicators aimed at the care of burns, generally developed through a consensus among experts [2,4,[7][8][9]. However, none of these instruments are specific to evaluate hospital care.…”