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Pivetta LGA, Antunes PDESL, Shimoda GM, Parreira JG, Perlingeiro JAG, Assef JC. Trauma Registry: Trauma Quality indicators analysis in hospitalized patients. Rev Col Bras Cir 2024; 51:e20243604. [PMID: 38597571 PMCID: PMC11185059 DOI: 10.1590/0100-6991e-20243604-en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 12/04/2023] [Indexed: 04/11/2024] Open
Abstract
PURPOSE to consolidate a Trauma Register (TR) trough REDCap data acquisition platform and to validate, in this context, local Quality Indicators (QI) as improvement opportunities in trauma management. METHODS continuous data acquisition of all patients admitted in Irmandade da Santa Casa de Misericórdia de São Paulo adult Trauma bay and it's validation in REDCap platform; 6 months retrospective cohort of QI impact in length of hospitalar stay, complications and mortality. Fisher, Chi-squared, Wilcoxon and Kruskal-Wallis tests were used to correlate QIs fails with the endpoints, considering p<0.05 and CI <95% as statically significant. RESULTS 465 were admitted in Trauma bay, with 137 patients hospitalized (29.5%); the number of QIs compromised were related with more complications (p=0.075) and increased length of stay (p=0.028), especially the delay in open fracture's surgical management, which increased the severe complications' incidence (p=0.005). CONCLUSION the REDCap data acquisition platform is useful as a tool for multi center TR implementation, from ethical and logistical point of view; nevertheless, the proposed QIs are validated as attention points in trauma management, allowing improvements in traumatized patients treatment.
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Affiliation(s)
| | | | | | - José Gustavo Parreira
- Irmandade da Santa Casa de Misericórdia de São Paulo, Serviço de Emergência - São Paulo - SP - Brasil
| | | | - Jose Cesar Assef
- Irmandade da Santa Casa de Misericórdia de São Paulo, Serviço de Emergência - São Paulo - SP - Brasil
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Berg J, Alvesson HM, Roy N, Ekelund U, Bains L, Chatterjee S, Bhattacharjee PK, David S, Gupta S, Kamble J, Khajanchi M, Lal P, Malhotra V, Meher R, Mishra A, Mohan LN, Petzold M, Saxena R, Shrivastava P, Singh R, Soni KD, Sural S, Gerdin Wärnberg M. Perceived usefulness of trauma audit filters in urban India: a mixed-methods multicentre Delphi study comparing filters from the WHO and low and middle-income countries. BMJ Open 2022; 12:e059948. [PMID: 35680271 PMCID: PMC9185581 DOI: 10.1136/bmjopen-2021-059948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare experts' perceived usefulness of audit filters from Ghana, Cameroon, WHO and those locally developed; generate context-appropriate audit filters for trauma care in selected hospitals in urban India; and explore characteristics of audit filters that correlate to perceived usefulness. DESIGN A mixed-methods approach using a multicentre online Delphi technique. SETTING Two large tertiary hospitals in urban India. METHODS Filters were rated on a scale from 1 to 10 in terms of perceived usefulness, with the option to add new filters and comments. The filters were categorised into three groups depending on their origin: low and middle-income countries (LMIC), WHO and New (locally developed), and their scores compared. Significance was determined using Kruskal-Wallis test followed by Wilcoxon rank-sum test. We performed a content analysis of the comments. RESULTS 26 predefined and 15 new filter suggestions were evaluated. The filters had high usefulness scores (mean overall score 9.01 of 10), with the LMIC filters having significantly higher scores compared with those from WHO and those newly added. Three themes were identified in the content analysis relating to medical relevance, feasibility and specificity. CONCLUSIONS Audit filters from other LMICs were deemed highly useful in the urban India context. This may indicate that the transferability of defined trauma audit filters between similar contexts is high and that these can provide a starting point when implemented as part of trauma quality improvement programmes in low-resource settings.
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Affiliation(s)
- Johanna Berg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Emergency and Internal Medicine, Skane University Hospital, Malmo, Sweden
| | | | - Nobhojit Roy
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- The George Institute for Global Health India, New Delhi, Delhi, India
| | - Ulf Ekelund
- Emergency Medicine, Department of Clinical Sciences, Lund University Faculty of Medicine, Lund, Sweden
| | - Lovenish Bains
- Department of Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
- WHO Collaboration Centre for Research in Surgical Care Delivery In Low and Middle-Income Countries, Mumbai, Maharashtra, India
| | - Shamita Chatterjee
- Department of Surgery, Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India
| | | | - Siddarth David
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Doctors For You, Mumbai, Maharashtra, India
| | - Swati Gupta
- Department of Radiodiagnosis and Imaging, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Jyoti Kamble
- Doctors For You, Mumbai, Maharashtra, India
- School of Public health, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
| | - Monty Khajanchi
- WHO Collaboration Centre for Research in Surgical Care Delivery In Low and Middle-Income Countries, Mumbai, Maharashtra, India
- Department of Surgery, Seth GS Medical College and KEM Hospital, Mumbai, Maharashtra, India
| | - Pawanindra Lal
- Department of Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Vikas Malhotra
- Department of ENT and Head & Neck Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Ravi Meher
- Department of ENT and Head & Neck Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Anurag Mishra
- Department of Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | | | - Max Petzold
- School Public Health and Community Medicine, Institute of Medicine, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
| | - Ritu Saxena
- Department of Accident and Emergency, Lok Nayak Hospital, New Delhi, India
| | - Prabhat Shrivastava
- Department of Burns and Plastic Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Rajdeep Singh
- Department of Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Kapil Dev Soni
- Department of Critical and Intensive Care, All India Institute of Medical Sciences, New Delhi, Delhi, India
| | - Sumit Sural
- Department of Orthopaedic Surgery, Maulana Azad Medical College, New Delhi, Delhi, India
| | - Martin Gerdin Wärnberg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Function Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden
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