Quality improvement practices used by teaching versus non-teaching trauma centres: analysis of a multinational survey of adult trauma centres in the United States, Canada, Australia, and New Zealand

BMC Surgery

Research Article

Niklas H Bobrovitz¹  Henry T Stelfox²  Mauricio B Ferri²  Vikas P Chaubey²  Derek J Roberts³ 

[1] Department of Community Health Sciences, University of Calgary, Teaching, Research & Wellness Building, 3rd Floor, 3280 Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada;Department of Critical Care Medicine, University of Calgary, Foothills Medical Centre, McCaig Tower, 3134 Hospital Drive NW, T2N 2T9, Calgary, AB, Canada;Department of Community Health Sciences, University of Calgary, Teaching, Research & Wellness Building, 3rd Floor, 3280 Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada;Department of Surgery, University of Calgary, Foothills Medical Centre, North Tower, 10th Floor, 1403 - 29th Street NW, T2N 2T9, Calgary, AB, Canada;Department of Community Health Sciences, University of Calgary, Teaching, Research & Wellness Building, 3rd Floor, 3280 Hospital Drive NW, T2N 4Z6, Calgary, AB, Canada;

关键词: Trauma quality improvement;    Teaching status;    Survey;   

DOI  :  10.1186/1471-2482-14-112

 received in 2014-01-01, accepted in 2014-12-17,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundAlthough studies have suggested that a relationship exists between hospital teaching status and quality improvement activities, it is unknown whether this relationship exists for trauma centres.MethodsWe surveyed 249 adult trauma centres in the United States, Canada, Australia, and New Zealand (76% response rate) regarding their quality improvement programs. Trauma centres were stratified into two groups (teaching [academic-based or –affiliated] versus non-teaching) and their quality improvement programs were compared.ResultsAll participating trauma centres reported using a trauma registry and measuring quality of care. Teaching centres were more likely than non-teaching centres to use indicators whose content evaluated treatment (18% vs. 14%, p < 0.001) as well as the Institute of Medicine aim of timeliness of care (23% vs. 20%, p < 0.001). Non-teaching centres were more likely to use indicators whose content evaluated triage and patient flow (15% vs. 18%, p < 0.001) as well as the Institute of Medicine aim of efficiency of care (25% vs. 30%, p < 0.001). While over 80% of teaching centres used time to laparotomy, pulmonary complications, in hospital mortality, and appropriate admission physician/service as quality indicators, only two of these (in hospital mortality and appropriate admission physician/service) were used by over half of non-teaching trauma centres. The majority of centres reported using morbidity and mortality conferences (96% vs. 97%, p = 0.61) and quality of care audits (94% vs. 88%, p = 0.08) while approximately half used report cards (51% vs. 43%, p = 0.22).ConclusionsTeaching and non-teaching centres reported being engaged in quality improvement and exhibited largely similar quality improvement activities. However, differences exist in the type and frequency of quality indicators utilized among teaching versus non-teaching trauma centres.

【 授权许可】

CC BY   
© Chaubey et al.; licensee BioMed Central. 2014