Reducing Avoidable Admissions for Children with Isolated Skull Fractures

Currently, most children with isolated skull fractures (e.g., without intracranial injury) are admitted to hospitals, despite being at low risk for complications. These authors assessed the effect of a quality-improvement initiative intended to decrease the rate of potentially avoidable admissions at a single tertiary care academic children's hospital.

The initiative included implementing an evidence-based clinical guideline along with multidisciplinary educational initiatives, e-reminders, and periodic updates. In addition, attending emergency physicians caring for children with isolated skull fractures received a survey at the time of admission that assessed barriers to guideline adherence while emphasizing the evidence supporting the guid…