P99 The definition of quality and measurement of the resuscitation of traumatically injured children – a phenomenographic study

Trauma is the leading cause of death of children. 1 The quality of resuscitation of a severely injured child is very highly valued both as a team and as an individual member of a team. With no current definition of what a high-quality resuscitation of an injured child constitutes or a mechanism to capture this, both quality assurance and future improvement is significantly hampered. The purpose of this study was to describe the perceptions of trauma team members and administrators alike, as to what constitutes a high-quality resuscitation of a severely injured child and how to measure this. We describe the perceptions of thirty-six UK trauma team members and governance administrators from three UK district general hospitals. A phenomenographic methodology as described by Marton was employed. 2 This approach qualitatively maps the collective different ways in which people experience, conceptualise and understand various aspects of a phenomena. In this study the phenomena is the resuscitation of a severely traumatically injured child and how we measure it. This approach also highlights how the variation of perspectives is inter-related and provides an insight how of the architecture of the variation defines the phenomenon. 2,3,4 The study followed the Consolidated criteria for reporting qualitative studies. 5 Analysis of differing and synergistic perceptions identified six categories which define high-quality resuscitation and how we can measure this quality, these are system, team, process, individual, data and culture. A hierarchy of perceptions is evident from a simple process-driven perspective to a complex architecture of quality and measurement that combines the six categories. Combining this with the shared and divergent views of both trauma team members and trauma governance administrators further defines what we currently understand, in terms the quality of resuscitation and the measurement thereof. Our current inability to define quality hinders both quality assurance at present and quality improvement in the future. Our future ability to capture and disseminate system, team, process, individual, data and culture perspectives of the quality of a resuscitation could be a key advance patient care. References . Krug E, Sharma G, Lozano R. The global burden of injuries. American Journal of Public Health 2000;90:523–6. . Marton F. Phenomenography-describing conceptions of the world around us. Instr Sci 1981;10:177–200. . Barnard A, McCosker H, Gerber R. Phenomenography: A qualitative research approach for exploring understanding in health care. Qual Health Res 1999;9:212–26. . Sjostrom B, Dahlgren LO. Applying phenomenography in nursing research. J Adv Nurs 2002;40:339–45. . Consolidated criteria for reporting qualitative studies (COREQ): 32-item checklist . https://academic.oup.com/intqhc/article/19/6/349/1791966/Consolidated-criteria-for-reporting-qualitative. last accessed 06 July 2017.