A management model for admission and treatment of pediatric trauma cases

A management model for admission and treatment of pediatric trauma employing the Theory of Constraints (TOC) was designed after scrutinizing the frequent management of Pediatric trauma, in less than optimal facilities by providers lacking training and experience in managing pediatric patients with severe injury.

Interviews of 17 highly experienced policymakers, senior nursing managers and medical managers in pediatrics and trauma were conducted and analyzed. Using TOC, undesirable effects (UDEs) and core challenges were recognized, and a focused current reality tree (CRT) was designed, followed by constructing a management model for optimally admitting and treating pediatric trauma.

This CRT was described based on 4 recognized UDEs focusing on the deficiency of (1) precise descriptions of the case manager in pediatric trauma; (2) uniform standards concerning the suitable site for admitting pediatric trauma, (3) standard guidelines and protocols for treating cases of trauma and for the training of trauma medical teams; and (4) standard guidelines for evacuating pediatric trauma patients. 

The management model for treatment and admission of pediatric trauma comprises 3 primary factors: human resources, hospital policy regarding the suitable emergency department (ED) for pediatric trauma patients and precise definitions concerning children and trauma levels. These factors encompass components that need a precise definition for a medical Centre to be established for admitting and treating pediatric trauma patients.

It was inferred that the ED for pediatric trauma cases must contain operating rooms, intensive care beds, an imaging unit, laboratories and equipment suited to treat children along with staff trained to treat children with trauma. 

This could further be refined by categorizing medical centers based on their trauma treatment capabilities and ability to treat assorted severities of pediatric trauma cases.

Source: Tashlizky Madar R, Goldberg A, Newman N, Waisman Y, Greenberg D, Adini B. A management model for admission and treatment of pediatric trauma cases. Isr J Health Policy Res. 2021 Dec 13;10(1):73. doi: 10.1186/s13584-021-00506-5.


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