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World Journal of Surgery

Published in:

01-05-2009

Establishing the Evidence Base for Trauma Quality Improvement: A Collaborative WHO-IATSIC Review

Authors: Catherine J. Juillard, Charles Mock, Jacques Goosen, Manjul Joshipura, Ian Civil

Published in: World Journal of Surgery | Issue 5/2009

Abstract

Background

Quality improvement (QI) programs are an integral part of well-developed trauma systems. However, they have not been extensively implemented globally. To promote greater use of effective QI programs, the World Health Organization (WHO) and the International Association for Trauma Surgery and Intensive Care (IATSIC) have been collaboratively developing the upcoming Guidelines for Trauma Quality Improvement Programmes. As part of the development of this publication and to satisfy global demands for WHO guidelines to be evidence based, we conducted a thorough literature search on the effectiveness of trauma QI programs.

Methods

The review was based on a PubMed search of all articles reporting an outcome from a trauma QI program.

Results

Thirty-six articles were identified that reported results of evaluations of a trauma QI program or in which the trauma QI program was integrally related to identification and correction of specific problems. Thirteen of these articles reported on mortality as their main outcome; 12 reported on changes in morbidity (infection rates, complications), patient satisfaction, costs, or other outcomes of tangible patient benefit; and 11 reported on changes in process of care. Thirty articles addressed hospital-based care; four system-wide care; and two prehospital care. Thirty-four articles reported an improvement in the outcome assessed; two reported no change; and none reported worsening of the outcome. Five articles also reported cost savings.

Conclusions

Trauma QI programs are consistently shown to improve the process of care, decrease mortality, and decrease costs. Further efforts to promote trauma QI globally are warranted. These findings support the further development and promulgation of the WHO-IATSIC Guidelines for Trauma QI Programmes.

WHO publications use British English spellings. As such "programme" is maintained in the name of the title of the publication, while "program" is used throughout the rest of the article.

TRISS: A scoring method that calculates probability of survival based on Revised Trauma Score (TR) and Injury Severity Score (ISS). This can be used to evaluate whether rates of death in a group of trauma patients is higher or lower than expected (z-score) when compared to pre-established norms.

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Title: Establishing the Evidence Base for Trauma Quality Improvement: A Collaborative WHO-IATSIC Review
Authors: Catherine J. Juillard
Charles Mock
Jacques Goosen
Manjul Joshipura
Ian Civil
Publication date: 01-05-2009
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 5/2009
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-009-9959-8

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Establishing the Evidence Base for Trauma Quality Improvement: A Collaborative WHO-IATSIC Review

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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