Table 2 The perspectives of the quality and measurement of acute stabilisation of a traumatically injured child

System: the organisational design to facilitate optimal performance.

Ready/pre-planned, critical incident reporting systems, equity of care, standards, prioritisation, value for money, feedback to team, feedback from major trauma centres, coffee room feedback, current lack of tools to measure quality, team-working tools, friends and family test during stabilisation, checklists, cognitive aids, audit.

Team: the mechanics of how the team functions.

Teamwork, leadership, communication, team satisfaction, supported teams, team performance monitoring, ongoing team training.

Process: the direct delivery of care to the patient.

Best care provision with resources available, best evidenced, following protocols (Advanced Trauma Life Support, European Trauma Course), timelines.

Individual: the innate personal perspective of healthcare providers.

Internal assessment by team members, personal desire, personal satisfaction, specifically trained/experienced, patient’s experience, patient-centred, safety of patient, perception of carers/parents.

Data: the facts and details collectable for analysis.

Patient outcomes (morbidity, mortality), adverse clinical events (sudden untoward incidents), clinical data, Trauma Audit Research Network data (timings), electronic patient record, retrospective note reviews, benchmarking against other hospitals.

Culture: the social behaviour and customs of the team and organisation.

Debriefings post-resuscitation, reflective practice, guardians/champions of quality, inter-professional discourse, approachability of senior clinicians.