Improving the evaluation of non-accidental trauma across multiple specialties at a single institution
Background Based on the presenting injury, patients undergoing abuse evaluation may be managed by different specialties. Our local child abuse specialist expressed concern over the variability in evaluation of patients presenting with injuries concerning for non-accidental trauma (NAT). The aim of t...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-01-01
|
| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/14/1/e002953.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832542672307355648 |
|---|---|
| author | Courtney Port Lani Kroese William Hauda |
| author_facet | Courtney Port Lani Kroese William Hauda |
| author_sort | Courtney Port |
| collection | DOAJ |
| description | Background Based on the presenting injury, patients undergoing abuse evaluation may be managed by different specialties. Our local child abuse specialist expressed concern over the variability in evaluation of patients presenting with injuries concerning for non-accidental trauma (NAT). The aim of this quality improvement project was to increase the percentage of patients for whom there is a concern for NAT who receive a guideline-adherent evaluation from 7.7% to 50% in 6 months’ time.Methods A committee of physician stakeholders developed criteria for a complete NAT evaluation which were integrated into an order panel with built-in clinical guidance for test selection within our electronic medical record. Data on the completeness of NAT evaluation in paediatric patients 0–18 years of age were collected before and after the order panel release and analysed by admitting service, injury category and equity factors.Results This initiative increased the percentage of patients with a guideline-adherent evaluation from a mean of 7.7% to 25% within 6 months’ time. The number of days between patients with complete evaluations decreased from 63 days to 35 days. Order panel utilisation increased to 55%, and the percentage of evaluation opportunities was more complete when the order panel was used (79% vs 92%).Conclusions Standardisation of NAT evaluations through creation of an order panel with a clinical decision tool resulted in more guideline-adherent evaluations. The potential reduction of bias in such evaluations remains an area of interest. |
| format | Article |
| id | doaj-art-a47c4858e3d44e6da5a5ae6aadfe5ad4 |
| institution | Kabale University |
| issn | 2399-6641 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Quality |
| spelling | doaj-art-a47c4858e3d44e6da5a5ae6aadfe5ad42025-02-03T19:05:09ZengBMJ Publishing GroupBMJ Open Quality2399-66412025-01-0114110.1136/bmjoq-2024-002953Improving the evaluation of non-accidental trauma across multiple specialties at a single institutionCourtney Port0Lani Kroese1William Hauda21 Pediatrics, Inova Fairfax Medical Campus, Falls Church, Virginia, USA1 Pediatrics, Inova Fairfax Medical Campus, Falls Church, Virginia, USA2 Inova Fairfax Medical Campus, Falls Church, Virginia, USABackground Based on the presenting injury, patients undergoing abuse evaluation may be managed by different specialties. Our local child abuse specialist expressed concern over the variability in evaluation of patients presenting with injuries concerning for non-accidental trauma (NAT). The aim of this quality improvement project was to increase the percentage of patients for whom there is a concern for NAT who receive a guideline-adherent evaluation from 7.7% to 50% in 6 months’ time.Methods A committee of physician stakeholders developed criteria for a complete NAT evaluation which were integrated into an order panel with built-in clinical guidance for test selection within our electronic medical record. Data on the completeness of NAT evaluation in paediatric patients 0–18 years of age were collected before and after the order panel release and analysed by admitting service, injury category and equity factors.Results This initiative increased the percentage of patients with a guideline-adherent evaluation from a mean of 7.7% to 25% within 6 months’ time. The number of days between patients with complete evaluations decreased from 63 days to 35 days. Order panel utilisation increased to 55%, and the percentage of evaluation opportunities was more complete when the order panel was used (79% vs 92%).Conclusions Standardisation of NAT evaluations through creation of an order panel with a clinical decision tool resulted in more guideline-adherent evaluations. The potential reduction of bias in such evaluations remains an area of interest.https://bmjopenquality.bmj.com/content/14/1/e002953.full |
| spellingShingle | Courtney Port Lani Kroese William Hauda Improving the evaluation of non-accidental trauma across multiple specialties at a single institution BMJ Open Quality |
| title | Improving the evaluation of non-accidental trauma across multiple specialties at a single institution |
| title_full | Improving the evaluation of non-accidental trauma across multiple specialties at a single institution |
| title_fullStr | Improving the evaluation of non-accidental trauma across multiple specialties at a single institution |
| title_full_unstemmed | Improving the evaluation of non-accidental trauma across multiple specialties at a single institution |
| title_short | Improving the evaluation of non-accidental trauma across multiple specialties at a single institution |
| title_sort | improving the evaluation of non accidental trauma across multiple specialties at a single institution |
| url | https://bmjopenquality.bmj.com/content/14/1/e002953.full |
| work_keys_str_mv | AT courtneyport improvingtheevaluationofnonaccidentaltraumaacrossmultiplespecialtiesatasingleinstitution AT lanikroese improvingtheevaluationofnonaccidentaltraumaacrossmultiplespecialtiesatasingleinstitution AT williamhauda improvingtheevaluationofnonaccidentaltraumaacrossmultiplespecialtiesatasingleinstitution |