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| Name | Class |
|---|---|
| National Trauma Research Institute | OTHER |
| The Alfred | OTHER |
| Monash University | OTHER |
| All India Institute of Medical Sciences |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Pre-intervention group | No Intervention | 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 not be introduced during this phase. | |
| Post-intervention group | Other | 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) |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| TQIM checklist | Other | The intervention phase will include an intense training period covering:
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| Measure | Description | Time Frame |
|---|---|---|
| TQIM Checklist compliance - preventability | TQIM Checklist compliance - % of cases for which it is agreed that care can be improved | Up to 14 months |
| Measure | Description | Time Frame |
|---|---|---|
| TQIM Checklist compliance - corrective action | TQIM Checklist compliance - % of cases (where it is agreed that care can be improved) for which at least one corrective action is agreed | Up to 14 months |
| In hospital risk-adjusted mortality |
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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:
Exclusion Criteria:
The exclusion criteria for the AITSC Trauma Registry are:
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| Name | Affiliation | Role |
|---|---|---|
| Mark C Fitzgerald, MBBS, MD | National Trauma Research Institute | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Vadilal Sarabhai Hospital | Ahmedabad | Gujarat | India | |||
| Lokmanya Tilak Municipal General Hospital |
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| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
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| OTHER |
| The George Institute for Global Health, Australia | OTHER |
| Sheth Vadilal Sarabhai General Hospital | OTHER |
| Guru Teg Bahadur Hospital | OTHER |
| Lokmanya Tilak Municipal Medical College and Hospital | OTHER |
| Centralised Accident and Trauma Services, Delhi, India | OTHER_GOV |
| GVK EMRI: Emergency Management and Research Institute | OTHER |
| Maharashtra Emergency Medical Services, India | OTHER |
| Nathiba Hargovandas Lakhmichand Municipal Medical College, India | UNKNOWN |
| University College of Medical Sciences, India | INDIV |
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In-hospital risk-adjusted mortality: The proportion of deaths amongst those with Injury Severity Score (ISS) >12 and <50.
| Up to 14 months |
| Hospital length of stay | Hospital length of stay | Up to 14 months |
| Time to emergency surgery | Time from hospital arrival to operating theatre for patients undergoing emergency surgery | Up to 14 months |
| Mumbai |
| India |
| Guru Teg Bahadur Hospital | New Delhi | India |
| JPN Apex Trauma Centre at All India Institute of Medical Sciences | New Delhi | India |