Trauma quality improvement program: a retrospective analysis from a middle eastern National Trauma Center
Fecha
2023-10-31Autor
Al-Thani, Hassan
El-Menyar, Ayman
Ahmad Khan, Naushad
Consu, Rafael
Peralta, Ruben
Abdelrahman, Husham
Rizoli, Sandro
Metadatos
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The Trauma Quality Improvement Program (American College of Surgery
(ACS-TQIP)) uses the existing infrastructure of the Committee on Trauma programs and provides
feedback to participating hospitals on risk-adjusted outcomes. This study aimed to analyze and
compare the performance of the Level I Hamad Trauma Centre (HTC) with other TQIP participating
centers by comparing TQIP aggregate database reports. The primary goal was to pinpoint the
variations in adult trauma outcomes and quality measures, identify areas that need improvement,
and leverage existing resources to facilitate quality improvement. A retrospective analysis
was performed for the TQIP data from April 2019–March 2020 to April 2020–March 2021. We used the
TQIP methodology, inclusion and exclusion criteria, and outcomes. There were 915 patients
from Fall 2020 and 884 patients from Fall 2021 that qualified for the TQIP database. The HTC patients’
demographics differed from the TQIP’s aggregate data; they were younger, more predominantly
male, and had significantly different mechanisms of injury (MOI) with more traffic-related blunt
trauma. Penetrating injuries were more severe in the other centers. During the TQIP Fall 2020 report,
the HTC was a low outlier (good performer) in one cohort (all patients) and an average performer
in the remaining cohorts. However, during Fall 2021, the HTC showed an improvement and was
a low outlier in two cohorts (all patients and severe TBI patients). Overall, the HTC remained an
average performer during the report cycles. There was an improvement over time
in the risk-adjusted mortality, which reflects the continuous and demanding effort put together by
the trauma team. The ACS-TQIP for the external benchmarking of quality improvement could be a
contributor to better monitored patient care. Evaluating the TQIP data with emphases on appropriate
methodologies, quality measurements, corrective measures, and accurate reporting is warranted.
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