Pediatric Quality Indicators Overview  

The Pediatric Quality Indicators (PDIs) are a set of measures that can be used with hospital inpatient discharge data to provide a perspective on the quality of pediatric healthcare. Specifically, PDIs screen for problems that pediatric patients experience as a result of exposure to the healthcare system and that may be amenable to prevention by changes at the system or provider level.

Development of quality indicators for the pediatric population involves many of the same challenges associated with the development of quality indicators for the adult population. These challenges include the need to carefully define indicators using administrative data, establish validity and reliability, detect bias and design appropriate risk adjustment, and overcome challenges of implementation and use. However, the special population of children invokes additional, special challenges. Four factors—differential epidemiology of child healthcare relative to adult healthcare, dependency, demographics, and development—can pervade all aspects of children’s healthcare; simply applying adult indicators to younger age ranges is insufficient

This PDIs focus on potentially preventable complications and iatrogenic events for pediatric patients treated in hospitals, and on preventable hospitalizations among pediatric patients.

The Pediatric Quality Indicators are a part of Agency Healthcare Research and Quality (AHRQ) Quality Indicators (QIs) developed by investigators at Stanford University and the University of California under a contract with AHRQ.

The PDIs are a software tool distributed free by AHRQ. The software can be used to help hospitals identify potential adverse events that might need further study. The PDI software programs can be applied to any hospital inpatient administrative data. These data are readily available and relatively inexpensive to use.

The PDIs are the fourth in a four-part set of AHRQ Quality Indicators (QIs).

PDI facts

Pediatric Quality Indicators:

• Apply to the special characteristics of the pediatric population.
• Screen for problems that pediatric patients experience as a result of exposure to the healthcare system and that may be amenable to prevention by changes at the provider level or area level.
• Help to evaluate preventive care for children in an outpatient setting, and most children are rarely hospitalized.
• Are free and publicly available.
• Are available for download.

The PDIs provide a perspective on patient safety events using hospital administrative data, which are readily available and relatively inexpensive to use.

The PDIs include 13 Provider-level and 5 Area-level Indicators.

Provider-level Pediatric Quality Indicators (13 Indicators)

• Accidental Puncture or Laceration (PDI 1)
• Decubitus Ulcer (PDI 2)
• Foreign Body Left During Procedure (PDI 3)
• Iatrogenic Pneumothorax in Neonates at Risk (PDI 4)
• Iatrogenic Pneumothorax in Non-neonates (PDI 5)
• Pediatric Heart Surgery Mortality (PDI 6)
• Pediatric Heart Surgery Volume (PDI 7)
• Postoperative Hemorrhage or Hematoma (PDI 8)
• Postoperative Respiratory Failure (PDI 9)
• Postoperative Sepsis (PDI 10)
• Postoperative Wound Dehiscence (PDI 11)
• Selected Infections Due to Medical Care (PDI 12)
• Transfusion Reaction (PDI 13)

Area-level Pediatric Quality Indicators (5 Indicators)

• Asthma Admission Rate (PDI 14)
• Diabetes Short-Term Complication Rate (PDI 15)
• Gastroenteritis Admission Rate (PDI 16)
• Perforated Appendix Admission Rate (PDI 17)
• Urinary Tract Infection Admission Rate (PDI 18)