A qualitative study to identify opportunities for improving trauma quality improvement

J Crit Care. 2012 Dec;27(6):738.e1-7. doi: 10.1016/j.jcrc.2012.07.010. Epub 2012 Sep 19.

Abstract

Background: Quality improvement (QI) is a central tenant of trauma center accreditation in most countries, but its effectiveness is largely unknown. We sought to explore opportunities for improving trauma QI.

Methods: We performed a qualitative research study using grounded theory analyses of interviews with medical directors and program managers from 75 verified trauma centers sampled from the United States (n = 51), Canada (n = 14), and Australasia (Australia and New Zealand [n = 10]) to explore experiences with trauma QI activities and identify opportunities for improvement.

Results: Most trauma centers indicated that they perceived trauma QI to be important and devoted personnel for QI (data entry, data analyst, educator, nurse practitioner). Programs identified 5 principal opportunities to improve trauma QI: (1) ensure resource adequacy (human resources, registry maintenance, financial support, institutional support), (2) encourage stakeholder participation (engagement, communication, coordination), (3) ensure clinical relevance, (4) incorporate evidence-based tools, and (5) require provider and QI program accountability.

Conclusions: Quality improvement programs exist as accreditation requirements in most centers. However, trauma QI practices depend on a range of local and regional factors, and concrete opportunities for improvement that address impact and sustainability exist.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accreditation
  • Hospital Administration / standards*
  • Humans
  • Interviews as Topic
  • Qualitative Research
  • Quality Improvement / organization & administration*
  • Quality Indicators, Health Care
  • Trauma Centers / organization & administration*
  • Trauma Centers / standards
  • Wounds and Injuries / therapy*