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

<p style="text-align:justify;"> <b>Background:</b> Although 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.<br/><br/> <...

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Main Authors: Chaubey, V, Roberts, D, Ferri, M, Bobrovitz, N, Stelfox, H
Format: Journal article
Language:English
Published: BioMed Central 2014
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author Chaubey, V
Roberts, D
Ferri, M
Bobrovitz, N
Stelfox, H
author_facet Chaubey, V
Roberts, D
Ferri, M
Bobrovitz, N
Stelfox, H
author_sort Chaubey, V
collection OXFORD
description <p style="text-align:justify;"> <b>Background:</b> Although 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.<br/><br/> <b>Methods:</b> We 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.<br/><br/> <b>Results:</b> All 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 &lt; 0.001) as well as the Institute of Medicine aim of timeliness of care (23% vs. 20%, p &lt; 0.001). Non-teaching centres were more likely to use indicators whose content evaluated triage and patient flow (15% vs. 18%, p &lt; 0.001) as well as the Institute of Medicine aim of efficiency of care (25% vs. 30%, p &lt; 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).<br/><br/> <b>Conclusions:</b> Teaching 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. </p>
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spelling oxford-uuid:3d320f11-51f5-49cb-b5e0-e62c536787692022-03-26T14:17:58ZQuality 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 ZealandJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:3d320f11-51f5-49cb-b5e0-e62c53678769EnglishSymplectic Elements at OxfordBioMed Central2014Chaubey, VRoberts, DFerri, MBobrovitz, NStelfox, H <p style="text-align:justify;"> <b>Background:</b> Although 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.<br/><br/> <b>Methods:</b> We 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.<br/><br/> <b>Results:</b> All 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 &lt; 0.001) as well as the Institute of Medicine aim of timeliness of care (23% vs. 20%, p &lt; 0.001). Non-teaching centres were more likely to use indicators whose content evaluated triage and patient flow (15% vs. 18%, p &lt; 0.001) as well as the Institute of Medicine aim of efficiency of care (25% vs. 30%, p &lt; 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).<br/><br/> <b>Conclusions:</b> Teaching 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. </p>
spellingShingle Chaubey, V
Roberts, D
Ferri, M
Bobrovitz, N
Stelfox, H
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
title 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_short 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
title_sort 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
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