Quality of care indicators for the rehabilitation of children with traumatic brain injury

Objective: To develop measurement tools for assessing compliance with identifiable processes of inpatient care for children with traumatic brain injury (TBI) that are reliable, valid, and amenable to implementation.

Design: Literature review and expert panel using the RAND/UCLA Appropriateness Method and a Delphi technique.

Setting: Not applicable.

Participants: Children with TBI.

Interventions: Not applicable.

Main outcome measure: Quality of care indicators.

Results: A total of 119 indicators were developed across the domains of general management; family-centered care; cognitive-communication, speech, language, and swallowing impairments; gross and fine motor skill impairments; neuropsychologic, social, and behavioral impairments; school reentry; and community integration. There was a high degree of agreement on these indicators as valid and feasible quality measures for children with TBI.

Conclusions: These indicators are an important step toward building a better base of evidence about the effectiveness and efficiency of the components of acute inpatient rehabilitation for pediatric patients with TBI.