Carmen Gayle Cooper1, Maria Jose Santana, Henry T Stelfox. 1. 1Department of Kinesiology, University of Calgary, Calgary, Alberta, Canada. 2Department of Medicine, Institute for Public Health, University of Calgary, Calgary, Canada. 3Department of Critical Care Medicine, Institute for Public Health, University of Calgary, Calgary, Canada.
Abstract
OBJECTIVES: Quality assurance practices are structured performance improvement and patient safety processes designed to continuously monitor, evaluate, and improve the performance of a trauma program. These practices are integral in the provision of quality injury care, and yet no comprehensive description of existing quality improvement practices used by pediatric trauma centers is available. Therefore, we compared the quality improvement programs used in adult and pediatric trauma centers by performing a reanalysis of our recent survey of trauma quality improvement practices in Canada, United States, Australia, and New Zealand. DESIGN: Prospective observational study. SETTING: Pediatric and adult trauma centers in United States, Canada, and Australasia. PATIENTS: None. INTERVENTIONS: None. MEASUREMENTS: We surveyed 184 trauma centers verified by professional trauma organizations in the United States, Canada, and Australasia regarding their quality improvement programs. Centers were classified according to population served (adult, adult and pediatric, or pediatric patients), and quality improvement programs were compared using descriptive statistics. RESULTS: Most of the trauma centers reported engagement in quality improvement activities. Adult centers devoted a larger percentage of their quality indicators to the measurement of safety (adult 50% vs adult and pediatric 53% vs pediatric 38%, p < 0.001), whereas pediatric centers placed a greater emphasis on the timeliness of care (20% vs 24% vs 30%, p < 0.001). Few centers used quality indicators to measure the patient-centered nature of care, long-term outcomes, or secondary injury prevention. CONCLUSIONS: Opportunities for the improvement of pediatric quality improvement programs exist including a need to determine the optimal structure for trauma quality improvement, develop patient-centered quality indicators of injury care, measure long-term outcomes, and create measures of secondary injury prevention.
OBJECTIVES: Quality assurance practices are structured performance improvement and patient safety processes designed to continuously monitor, evaluate, and improve the performance of a trauma program. These practices are integral in the provision of quality injury care, and yet no comprehensive description of existing quality improvement practices used by pediatric trauma centers is available. Therefore, we compared the quality improvement programs used in adult and pediatric trauma centers by performing a reanalysis of our recent survey of trauma quality improvement practices in Canada, United States, Australia, and New Zealand. DESIGN: Prospective observational study. SETTING: Pediatric and adult trauma centers in United States, Canada, and Australasia. PATIENTS: None. INTERVENTIONS: None. MEASUREMENTS: We surveyed 184 trauma centers verified by professional trauma organizations in the United States, Canada, and Australasia regarding their quality improvement programs. Centers were classified according to population served (adult, adult and pediatric, or pediatric patients), and quality improvement programs were compared using descriptive statistics. RESULTS: Most of the trauma centers reported engagement in quality improvement activities. Adult centers devoted a larger percentage of their quality indicators to the measurement of safety (adult 50% vs adult and pediatric 53% vs pediatric 38%, p < 0.001), whereas pediatric centers placed a greater emphasis on the timeliness of care (20% vs 24% vs 30%, p < 0.001). Few centers used quality indicators to measure the patient-centered nature of care, long-term outcomes, or secondary injury prevention. CONCLUSIONS: Opportunities for the improvement of pediatric quality improvement programs exist including a need to determine the optimal structure for trauma quality improvement, develop patient-centered quality indicators of injury care, measure long-term outcomes, and create measures of secondary injury prevention.
Authors: Omar Z Ahmed; Richard Holubkov; J Michael Dean; Tellen D Bennett; Kathleen L Meert; Robert A Berg; Christopher J L Newth; Joseph A Carcillo; Randall S Burd; Murray M Pollack Journal: J Trauma Acute Care Surg Date: 2019-05 Impact factor: 3.313
Authors: Kate Curtis; Rebecca Mitchell; Amy McCarthy; Kellie Wilson; Connie Van; Belinda Kennedy; Gary Tall; Andrew Holland; Kim Foster; Stuart Dickinson; Henry T Stelfox Journal: Scand J Trauma Resusc Emerg Med Date: 2017-02-28 Impact factor: 2.953
Authors: Elinore J Kaufman; Therese S Richmond; Douglas J Wiebe; Sara F Jacoby; Daniel N Holena Journal: JAMA Surg Date: 2017-09-01 Impact factor: 14.766