The development of a value-based healthcare burns core set for children after burn injury.

Abstract

This study, involving stakeholders from three Dutch burn centres was conducted to optimize person-centered burn care and improving patient-relevant outcomes, as part of a value-based healthcare (VBHC) approach. Transparent measurement and reporting of patients' relevant outcomes is essential to determine VBHC algorithms, and requires a core set of the most patient-relevant outcomes. The aim of this study was to develop a VBHC-burns core set for children. We conducted a two-round modified Delphi study to reach consensus among caregivers of pediatric burn patients (<18 years old), healthcare professionals and researchers to determine the most important outcomes. In each round, items were selected if at least 70% of each group considered an item 'important'. In the first round a 9-point Likert scale and in the second round a yes/no scale was used to rate if items are important. A total of 62 items were included in the Delphi study and 141 participants (60 caregivers of pediatric patients and 81 professionals) completed the first round. In this round, 10 items were included in the VBHC-burns core set: physical functioning, scar contraction, quality of life, pain, itchiness, sleep quality, mobility of functional areas, mental health, depression and the possibility of executing hobbies. The second and last Delphi round was completed by 68 participants in total and resulted in the addition of 3 items: anxiety, self-confidence, return to school. All outcomes were adapted and aligned with available patient reported outcome measures (PROMs). This study established a VBHC burns core outcome set, consisting of a holistic set of outcomes that are important for children with burn injuries. The VBHC burns core outcome set is implemented in our routine burn aftercare program, enabling systematic monitoring and analysis of outcomes that matter to pediatric patients and carers. This supports personalized care, shared decision-making, and patient empowerment.