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9789241597746

Guidelines for Trauma Quality Improvement Programmes

by
  • ISBN13:

    9789241597746

  • ISBN10:

    9241597747

  • Edition: 1st
  • Format: Paperback
  • Copyright: 2009-09-01
  • Publisher: STYLUS PUBLISHING LLC

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Summary

In order to promote greater implementation of effective, affordable and sustainable trauma systems globally, the World Health Organization and the International Association for Trauma Surgery and Intensive Care have worked collaboratively to produce these guidelines on trauma quality improvement. The response to the growing problem of injury needs to include the improvement of care of the injured. Quality improvement (QI) programs offer an affordable and sustainable means to implement such improvements. These programs enable health care institutions to better monitor trauma care services, better detect problems in care, and more effectively enact and evaluate corrective measures targeted at these problems. The goal of this publication is to give guidance on ways in which health care institutions globally can implement QI programs oriented to strengthening care of the injured. This guidance is intended to be universally applicable to all countries, no matter what their economic level. These guidelines provide basic definitions and an overview of the field of QI, so that those not familiar with this field will have a working knowledge of it. Evidence of the benefit of QI in general and trauma QI in particular is then laid out. The main part of the publication reviews the most common methods of trauma QI, written in a how-do-to fashion. This covers a wide range of techniques. The first two of these are especially emphasized as ways in which to strengthen trauma QI in the setting of low-income and middle-income countries.

Table of Contents

Prefacep. v
Contributorsp. vii
Acknowledgementsp. viii
Executive Summaryp. 1
Introductionp. 4
Overview of quality improvementp. 6
Definitions and basics of quality improvementp. 6
Elements of quality improvementp. 9
Benefits of quality improvement programmesp. 13
Review of benefits of trauma quality improvement in the medical literaturep. 13
Experience of trauma quality improvement in low- and middle-income countriesp. 14
Experience of quality improvement in other fields in low-and middle-income countriesp. 16
Status of trauma quality improvement globallyp. 19
Techniques of trauma quality improvementp. 22
Morbidity and mortality (M & M) conferencesp. 22
Trauma quality improvement committeep. 23
Preventable death panel reviewp. 25
Constituting the panelp. 26
Preparation of data for the reviewp. 27
Specifics of the case review processp. 30
Inclusion of involved care providers on the panel: potential for biasp. 31
Preventable death panels: documentation of discussion and analysisp. 32
Preventable death panels: a summaryp. 32
Tracking of audit filters, complications, errors, adverse events, and sentinel eventsp. 34
Audit filtersp. 34
Usefulness of audit filtersp. 36
Complications, adverse events, errors, and sentinel eventsp. 37
Classification of errorsp. 40
Statistical methods: risk-adjusted mortalityp. 40
Corrective strategies and closing the loopp. 44
Guidelines, pathways, and protocolsp. 44
Targeted educationp. 44
Actions for improvement targeted at specific providersp. 46
Enhanced resources, facilities, or communicationp. 47
Closing the loopp. 48
System-wide and prehospital quality improvementp. 49
Role of medical records and trauma registryp. 51
Appropriateness of different techniques at different levels of the health care systemp. 54
Overlap of these guidelines with other activitiesp. 57
Clinical algorithmsp. 57
Patient safetyp. 58
Strengthening of health care managementp. 59
Referencesp. 60
Annexesp. 68
Details of literature review of benefits of trauma quality improvementp. 68
Sample quality improvement tracking formp. 77
Sample data sheet for use in preventable death panel reviewsp. 79
Sample individual cases for reviewp. 81
Table of Contents provided by Ingram. All Rights Reserved.

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