Structured Trauma Quality Improvement Meetings at Four Trauma Centres in India: Protocol for a Prospective Observational Study to Assess Effectiveness
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Major Trauma
- Sponsor
- Dr Gerard O'Reilly
- Enrollment
- 1500
- Locations
- 4
- Primary Endpoint
- TQIM Checklist compliance - preventability
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
A prospective before-and-after study to evaluate the effect of implementing a Trauma Quality Improvement protocol on the process of Trauma Quality Improvement meetings and major trauma patient outcomes at four trauma centres in India.
Detailed Description
This project will be conducted as a prospective before-and-after study at four major trauma centres in India, with the intervention occurring between pre- and post-intervention phases. Included in the study will be all patients presenting to any of the four trauma hospitals with a potentially life-threatening or limb-threatening injury. The intervention will be the introduction of a structured Trauma Quality Improvement Meeting (TQIM), using a checklist and training program. The primary outcome will be compliance with the TQIM checklist, measured as the proportion of discussed cases (trauma deaths) for which problems with care, preventability and corrective actions were discussed and / or agreed. The secondary outcomes will include in-hospital risk-adjusted mortality, hospital length of stay and time to emergency surgery. Data collection will occur at all meetings at the four trauma hospitals at which trauma deaths are discussed. Data will also be collected in a dedicated trauma registry.
Investigators
Dr Gerard O'Reilly
Principal Investigator
National Trauma Research Institute
Eligibility Criteria
Inclusion Criteria
- •All patients presenting to any of the four study sites with a potentially life-threatening or limb-threatening injury. Specifically, all presenting injured patients triaged as "Red" or "Yellow" according to the Australia-India Trauma Systems Collaboration (AITSC) Trauma Triage Protocol, will meet the screening criteria for data collection. Retrospective inclusion in the registry will be continued for all screened patients presenting to any of the included hospitals with injury (including near-drowning) as the primary diagnosis and with at least one of the following criteria:
- •Admission to hospital
- •Death after triage but before admission
Exclusion Criteria
- •The exclusion criteria for the AITSC Trauma Registry are:
- •Death at scene
- •Alive at triage but not admitted to hospital
- •Isolated poisoning
- •Isolated burns
- •Single digit finger or toe amputations
Outcomes
Primary Outcomes
TQIM Checklist compliance - preventability
Time Frame: Up to 14 months
TQIM Checklist compliance - % of cases for which it is agreed that care can be improved
Secondary Outcomes
- Hospital length of stay(Up to 14 months)
- Time to emergency surgery(Up to 14 months)
- In hospital risk-adjusted mortality(Up to 14 months)
- TQIM Checklist compliance - corrective action(Up to 14 months)