Equity Report Cards for Acute Pain in Injured Children

Not yet recruiting at 1 trial location

Overseen By Caleb E Ward, MD, MPH

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Children's National Research Institute

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if 'Equity Report Cards' can ensure equal pain care for children of all races and ethnicities after injuries. It focuses on how emergency medical services (EMS) recognize and treat pain in injured children. The trial will distribute these report cards to assess their impact on reducing disparities. Children under 18 treated by the DC Fire and Emergency Medical Services for an injury may be eligible to participate. As an unphased trial, this study offers a unique opportunity to contribute to improving equitable healthcare for children.

Do I need to stop my current medications to join the trial?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that the Equity Report Cards are safe for use in EMS?

Research has shown that using report cards to improve healthcare is generally safe for both patients and providers. One study on nursing found that report cards can enhance the quality and safety of patient care by linking nursing outcomes to better patient results. Report cards can increase healthcare providers' awareness of their performance and encourage improvements in care, including pain management.

While no specific studies exist on "Equity Report Cards" for treating children's pain, similar tools have shown promise in improving care quality. Report cards in healthcare focus on improving processes rather than introducing new drugs or treatments, so the risk of harm remains low. The goal is to help emergency medical workers treat children's pain fairly, regardless of race or ethnicity.

Overall, this approach aims to identify gaps in care and motivate healthcare workers to address them, making pain treatment more equal and effective without adding new medical risks. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Equity Report Cards because they offer a novel approach to addressing disparities in pain management for injured children. Unlike traditional treatments that focus directly on medication or physical interventions, this method aims to improve equity by analyzing and distributing feedback on care practices. This could lead to more consistent and fair pain treatment across diverse groups, potentially improving outcomes by ensuring that all children receive the same level of attention and care, regardless of background.

What evidence suggests that Equity Report Cards are effective for reducing disparities in pain treatment for injured children?

Research has shown that managing pain in children is crucial to prevent both immediate and long-term problems. Studies have found that effective pain management during medical procedures improves children's overall health outcomes. By focusing on recognizing and treating pain, healthcare providers can better manage it in children. This trial uses Equity Report Cards to highlight differences in pain treatment among various racial and ethnic groups, promoting better care for everyone. Although direct data on the effectiveness of these Report Cards is limited, evidence supports the need for organized pain management to reduce these disparities. ^{1 2 4 6 7}

Who Is on the Research Team?

Caleb E Ward, MD, MPH

Principal Investigator

Children's National Research Institute

Are You a Good Fit for This Trial?

This trial is for Emergency Medical Services (EMS) providers who treat injured children. It aims to see if using 'Equity Report Cards' can reduce treatment differences based on race and ethnicity.

Inclusion Criteria

I am under 18 years old.

Assessed by District of Columbia Fire and Emergency Medical Services (DC FEMS)

My main health issue is due to an injury.

Exclusion Criteria

N/A

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Data Collection

Collection of two years of retrospective data to establish a baseline

2 months

Intervention Phase 1

Distribution of EMS Agency-level 'Equity Report Cards' to agency leadership and frontline EMS providers

5 months

Intervention Phase 2

Distribution of Battalion-level 'Equity Report Cards' to agency leadership and frontline EMS providers

5 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Equity Report Cards

Trial Overview The intervention being tested is the use of 'Equity Report Cards' in EMS settings, which are designed to monitor and improve how pain in injured children is recognized and treated, focusing on reducing racial and ethnic disparities.

How Is the Trial Designed?

Group I: Intervention Experimental Treatment 1 Intervention

Distribution of Equity Report Cards

Who Is Running the Clinical Trial?

Children's National Research Institute

Lead Sponsor

Trials

227

Recruited

258,000+

Doris Duke Charitable Foundation

Collaborator

Trials

65

Recruited

264,000+

American Academy of Pediatrics

Collaborator

Trials

46

Recruited

4,071,000+

Published Research Related to This Trial

In a study of 6,376 children treated in pediatric emergency departments, 3.0% experienced at least one adverse event related to their care, highlighting a significant safety risk in this setting.

Most of these adverse events (76.5%) were deemed preventable, primarily due to management and diagnostic issues, indicating that there are clear opportunities for improving patient safety and care quality.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

How safe are paediatric emergency departments? A national prospective cohort study. Plint, AC., Newton, AS., Stang, A., et al.[2022]

The study introduced a new voluntary and anonymous reporting system for near-miss and patient harm events in a pediatric intensive care unit, highlighting its importance for enhancing patient safety.

The effectiveness of the Patient Safety Report was demonstrated, showing it successfully captures incidents that could lead to patient harm, allowing for better assessment and prevention strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of an anonymous reporting system on near-miss and harmful medical error reporting in a pediatric intensive care unit. Grant, MJ., Larsen, GY.[2022]

The Brazilian Portuguese version of the Pediatric Trigger Toolkit was successfully translated and adapted for use in Brazilian hospitals, involving a thorough validation process that included expert consensus and cultural adaptation.

The toolkit demonstrated a positive predictive value of 13.51% for identifying adverse drug events in pediatric patients, with antihistamine triggers being the most effective, indicating its potential utility in improving patient safety.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Brazilian Portuguese version of the Pediatric Trigger Toolkit is applicable to measure the occurrence of adverse drug events in Brazilian pediatric inpatients. Silva, LT., Modesto, ACF., Martins, RR., et al.[2020]

Citations

1. finance.yahoo.com finance.yahoo.com/news/acute-pain-market-analysis-report-105700249.html

Acute Pain Market Analysis Report 2025-2035 The acute pain market is rapidly evolving, driven by the increasing demand for non-opioid pain management solutions amidst growing concerns ...

2. hhs.gov hhs.gov/sites/default/files/pain-mgmt-best-practices-draft-final-report-05062019.pdf

Pain Management Best Practices Inter-Agency Task Force ... The report emphasizes the development of an effective pain treatment plan after proper evaluation to establish a diagnosis with measurable ...

3. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12459512/

Digital health solutions for caregivers of children ... Well-managed acute pain procedures can minimize the negative immediate and long-term outcomes. In managing acute pain procedures, both the ...

4. bmjpaedsopen.bmj.com bmjpaedsopen.bmj.com/content/8/Suppl_7/e002610

Implementation of the WHO standards to assess quality ... The proportion of children treated for pain was 28.9% (n=970) again with a wide range (5.3%–56.3%, p<0.001).

5. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8918119/

Managing acute pain in children presenting to the emergency ... This document focuses pain management and distress mitigation strategies for the brief diagnostic and therapeutic procedures commonly performed.

6. researchgate.net researchgate.net/publication/11146707_Report_cards_Relevance_for_nursing_and_patient_care_safety

Report cards: Relevance for nursing and patient care safety Potential opportunities for linking nursing practice outcomes to patient care quality and patient safety through a report card process are ...

7. michigan-open.org michigan-open.org/wp-content/uploads/2024/08/Peds-Surgical-Pain-Management-Toolkit-for-HCP.pdf

2024 Pediatric Surgical Pain Management Toolkit This toolkit focuses on prevention of opioid related complications in children and adolescents by intervening at the point many are first ...