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BMC Health Services Research
Published in: BMC Health Services Research 1/2016

Open Access 01-12-2016 | Study protocol

Outcome after polytrauma in a certified trauma network: comparing standard vs. maximum care facilities concept of the study and study protocol (POLYQUALY)

Authors: Michael Koller, Antonio Ernstberger, Florian Zeman, Julika Loss, Michael Nerlich, on behalf of the Trauma Network Eastern Bavaria (TNO)

Published in: BMC Health Services Research | Issue 1/2016

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Abstract

Background

The aim of this study is to evaluate the performance of the first certified regional trauma network in Germany, the Trauma Network Eastern Bavaria (TNO) addressing the following specific research questions: Do standard and maximum care facilities produce comparable (risk-adjusted) levels of patient outcome? Does TNO outperform reference data provided by the German Trauma Register 2008? Does TNO comply with selected benchmarks derived from the S3 practice guideline? Which barriers and facilitators can be identified in the health care delivery processes for polytrauma patients?

Method/design

The design is based on a prospective multicenter cohort study comparing two cohorts of polytrauma patients: those treated in maximum care facilities and those treated in standard care facilities. Patient recruitment will take place in the 25 TNO clinics. It is estimated that n = 1.100 patients will be assessed for eligibility within a two-year period and n = 800 will be included into the study and analysed.
Main outcome measures include the TraumaRegisterQM form, which has been implemented in the clinical routine since 2009 and is filled in via a web-based data management system in participating hospitals on a mandatory basis. Furthermore, patient-reported outcome is assessed using the EQ-5D at 6, 12 and 24 months after trauma.
Comparisons will be drawn between the two cohorts. Further standards of comparisons are secondary data derived from German Trauma Registry as well as benchmarks from German S3 guideline on polytrauma.
The qualitative part of the study will be based on semi-standardized interviews and focus group discussions with health care providers within TNO. The goal of the qualitative analysis is to elucidate which facilitating and inhibiting forces influence cooperation and performance within the network.

Discussion

This is the first study to evaluate a certified trauma network within the German health care system using a unique combination of a quantitative (prospective cohort study) and a qualitative (in-depth facilitator/barrier analysis) approach. The information generated by this project will be used in two ways. Firstly, within the region the results of the study will help to optimize the pre-hospital and clinical management of polytrauma patients. Secondly, on a nationwide scale, influential decision-making bodies, such as the Ministries of Health, the Hospital Associations, sickness funds, insurance companies and professional societies, will be addressed. The results will not only be applicable to the region of Eastern Bavaria, but also in most other parts of Germany with a comparable infrastructure.

Trial registration

VfD_​Polyqualy_​12_​001978, 10.Jan.2013; German Clinical Trials Register DRKS00010039, 18.02.2016.
Literature
1.
Peters RM. Trauma causes greater loss of potential life years than heart disease and cancer combined. J Trauma. 1979;19:135.CrossRefPubMed
2.
3.
4.
Ruchholtz S. The Trauma Registry of the German Society of Trauma Surgery as a basis for interclinical quality management. A multicenter study of the German Society of Trauma Surgery. Unfallchirurg. 2000;103:30–7.CrossRefPubMed
5.
6.
7.
Champion HR, Copes WS, Sacco WJ, Lawnick MM, Keast SL, Bain LW, et al. The Major Trauma Outcome Study: establishing national norms for trauma care. J Trauma. 1990;30:1356–65.CrossRefPubMed
8.
MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL, et al. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med. 2006;354:366–78.CrossRefPubMed
9.
Twijnstra MJ, Moons KGM, Simmermacher RKJ, Leenen LPH. Regional trauma system reduces mortality and changes admission rates: a before and after study. Ann Surg. 2010;251:339–43.CrossRefPubMed
10.
Nicholl J, Turner J. Effectiveness of a regional trauma system in reducing mortality from major trauma: before and after study. BMJ. 1997;315:1349–54.CrossRefPubMedPubMedCentral
11.
Osterwalder JJ. Could a regional trauma system in eastern Switzerland decrease the mortality of blunt polytrauma patients? A prospective cohort study. J Trauma. 2002;52:1030–6.CrossRefPubMed
12.
Donabedian A. Evaluating the quality of medical care. Milbank Mem Fund Q. 1966;44(Suppl):166–206.CrossRefPubMed
13.
Schnabel M, Kill C, El-Sheik M, Sauvageot A, Klose KJ, Kopp I. From clinical guidelines to clinical pathways: development of a management-oriented algorithm for the treatment of polytraumatized patients in the acute period. Chirurg. 2003;74:1156–66.CrossRefPubMed
14.
Kingman-Brundage J. Service mapping: gaining a concrete perspective on service system design. In: Scheuing EE, Christopher WF, editors. The Service quality handbook. New York: Amacom; 1993. p. 148–63.
15.
Fließ S, Kleinaltenkamp M. Blueprinting the service company. J Business Res. 2004;57:392–404.CrossRef
16.
Rodie AR, Pol LG, Crabtree BF, McIlvain HE. Assessing quality. As pressure mounts for clinics to deliver quality, medical practice blueprints and genograms serve as useful tools. Mark Health Serv. 1999;19:16–24.PubMed
17.
18.
Ulvik A, Kvale R, Wentzel-Larsen T, Flaatten H. Quality of life 2–7 years after major trauma. Acta Anaesthesiol Scand. 2008;52:195–201.CrossRefPubMed
19.
Holbrook TL, Hoyt DB, Stein MB, Sieber WJ. Gender differences in long-term posttraumatic stress disorder outcomes after major trauma: women are at higher risk of adverse outcomes than men. J Trauma. 2002;53:882–8.CrossRefPubMed
20.
Lefering R, Huber-Wagner S, Nienaber U, Maegele M, Bouillon B. Update of the trauma risk adjustment model of the TraumaRegister DGU™: the Revised Injury Severity Classification, version II. Crit Care. 2014;18:476.CrossRefPubMedPubMedCentral
21.
Pirente N, Bouillon B, Schafer B, Raum M, Helling HJ, Berger E, Neugebauer E. Systematic development of a scale for determination of health-related quality of life in multiple trauma patients. The Polytrauma Outcome (POLO) Chart. Unfallchirurg. 2002;105:413–22.CrossRefPubMed
22.
23.
Patton MQ. Qualitative evaluation and research methods. 2nd ed. Newbury Park, Calif: Sage Publications; 1990.
24.
25.
Pape H, Grotz M, Schwermann T, Ruchholtz S, Lefering R, Rieger M, et al. The development of a model to calculate the cost of care for the severely injured--an initiative of the Trauma Register of the DGU. Unfallchirurg. 2003;106:348–57.CrossRefPubMed
26.
Lecky FE, Bouamra O, Woodford M, Alexandrescu R, O’Brien SJ. Epidemiology of Polytrauma. In: Pape H, Peitzman A, Schwab CW, Giannoudis PV, editors. Damage Control Management in the Polytrauma Patient. New York, NY: Springer New York; 2010. p. 13–24.CrossRef
27.
28.
Metadata
Title
Outcome after polytrauma in a certified trauma network: comparing standard vs. maximum care facilities concept of the study and study protocol (POLYQUALY)
Authors
Michael Koller
Antonio Ernstberger
Florian Zeman
Julika Loss
Michael Nerlich
on behalf of the Trauma Network Eastern Bavaria (TNO)
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-016-1468-5

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