• Henry T Stelfox, Carmen Gayle Cooper, and Maria Jose Santana.
• 1Department of Kinesiology, University of Calgary, Calgary, Alberta, Canada. 2Department of Medicine, Institute for Public Health, University of Calgary, Calgary, Canada. 3Department of Critical Care Medicine, Institute for Public Health, University of Calgary, Calgary, Canada.
• Pediatr Crit Care Me. 2013 Oct 1;14(8):e365-71.

ObjectivesQuality assurance practices are structured performance improvement and patient safety processes designed to continuously monitor, evaluate, and improve the performance of a trauma program. These practices are integral in the provision of quality injury care, and yet no comprehensive description of existing quality improvement practices used by pediatric trauma centers is available. Therefore, we compared the quality improvement programs used in adult and pediatric trauma centers by performing a reanalysis of our recent survey of trauma quality improvement practices in Canada, United States, Australia, and New Zealand.DesignProspective observational study.SettingPediatric and adult trauma centers in United States, Canada, and Australasia.PatientsNone.InterventionsNone.MeasurementsWe surveyed 184 trauma centers verified by professional trauma organizations in the United States, Canada, and Australasia regarding their quality improvement programs. Centers were classified according to population served (adult, adult and pediatric, or pediatric patients), and quality improvement programs were compared using descriptive statistics.ResultsMost of the trauma centers reported engagement in quality improvement activities. Adult centers devoted a larger percentage of their quality indicators to the measurement of safety (adult 50% vs adult and pediatric 53% vs pediatric 38%, p < 0.001), whereas pediatric centers placed a greater emphasis on the timeliness of care (20% vs 24% vs 30%, p < 0.001). Few centers used quality indicators to measure the patient-centered nature of care, long-term outcomes, or secondary injury prevention.ConclusionsOpportunities for the improvement of pediatric quality improvement programs exist including a need to determine the optimal structure for trauma quality improvement, develop patient-centered quality indicators of injury care, measure long-term outcomes, and create measures of secondary injury prevention.

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