Structured Trauma Quality Improvement Meetings at Four Trauma Centres in India
- Conditions
- Major TraumaInjuries Major
- Interventions
- Other: TQIM checklist
- Registration Number
- NCT03005509
- Lead Sponsor
- Dr Gerard O'Reilly
- 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.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 1500
-
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
-
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
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description Post-intervention group TQIM checklist All injured patients to the four intervention sites) and allocated to a red (1st) or yellow (2nd) priority triage category will be eligible for inclusion. The Trauma Quality Improvement Meeting (TQIM) checklist will be used at all Trauma Quality Improvement Meetings (TQIMs)
- Primary Outcome Measures
Name Time Method TQIM Checklist compliance - preventability Up to 14 months TQIM Checklist compliance - % of cases for which it is agreed that care can be improved
- Secondary Outcome Measures
Name Time Method Hospital length of stay Up to 14 months Hospital length of stay
Time to emergency surgery Up to 14 months Time from hospital arrival to operating theatre for patients undergoing emergency surgery
TQIM Checklist compliance - corrective action Up to 14 months TQIM Checklist compliance - % of cases (where it is agreed that care can be improved) for which at least one corrective action is agreed
In hospital risk-adjusted mortality Up to 14 months In-hospital risk-adjusted mortality: The proportion of deaths amongst those with Injury Severity Score (ISS) \>12 and \<50.
Trial Locations
- Locations (4)
Lokmanya Tilak Municipal General Hospital
🇮🇳Mumbai, India
JPN Apex Trauma Centre at All India Institute of Medical Sciences
🇮🇳New Delhi, India
Guru Teg Bahadur Hospital
🇮🇳New Delhi, India
Vadilal Sarabhai Hospital
🇮🇳Ahmedabad, Gujarat, India