Efect of implementing quality control management in the treatment of severely injured patients: a retrospective cohort study in a level I trauma center in China
Dublin Core
Title
Efect of implementing quality control management in the treatment of severely injured patients: a retrospective cohort study in a level I trauma center in China
Subject
Severe trauma, Multidisciplinary team, Quality control management, Mortality, Emergency operation
Description
Background: This study aimed to review the impact of quality control management on the treatment of severely
injured patients.
Methods: A retrospective analysis was conducted on patients with severe injury (injury severity score [ISS]≥16)
between January 1, 2018 and February 1, 2020. The selected patients were stratifed as follows. The patients who were
admitted prior to the implementation of quality control management—from January 1 to December 31, 2018—were
assigned to the PRE group; the POST group included patients who were admitted after the implementation—from
February 1, 2019 to February 1, 2020. Quality control management was implemented from January 1, 2019 to January
31, 2019. Parameters were compared to account for diferences in terms of demographics, surgical procedures, results
of process quality, and 72-h mortality.
Results: This study included 599 patients (PRE group: 212 males and 86 females; POST group: 228 males and 73
females; P=0.20). The extent of document completion was 97.3 and 100% in the PRE and POST groups, respectively
(P<0.001). There was no delay in the arrival of the trauma surgeons or the multidisciplinary team after implementation. However, following implementation of quality control management, there was a signifcant reduction in the
duration of basic diagnostics, time until receipt of laboratory data, time until frst computed tomography scan, time
until intubation, and time until an emergency operation (P<0.05). The deaths were caused by severe head injury (PRE:
5.4%, POST: 4%), hemorrhagic shock (PRE: 2.4%, POST: 0.7%), multiple-organ failure (PRE: 1.0%, POST: 0.3%), or other
causes (PRE: 0.7%, POST: 0.0%). The 72-h mortality decreased after the implementation of quality control management
(PRE vs. POST groups: 9.4 vs. 5.0%, P=0.04).
Conclusions: The implementation of quality control management resulted in decreased time to critical interventions, improved patient care efciency, and reduced early mortality. We recommend that this approach be replicated
at other trauma centers in China.
injured patients.
Methods: A retrospective analysis was conducted on patients with severe injury (injury severity score [ISS]≥16)
between January 1, 2018 and February 1, 2020. The selected patients were stratifed as follows. The patients who were
admitted prior to the implementation of quality control management—from January 1 to December 31, 2018—were
assigned to the PRE group; the POST group included patients who were admitted after the implementation—from
February 1, 2019 to February 1, 2020. Quality control management was implemented from January 1, 2019 to January
31, 2019. Parameters were compared to account for diferences in terms of demographics, surgical procedures, results
of process quality, and 72-h mortality.
Results: This study included 599 patients (PRE group: 212 males and 86 females; POST group: 228 males and 73
females; P=0.20). The extent of document completion was 97.3 and 100% in the PRE and POST groups, respectively
(P<0.001). There was no delay in the arrival of the trauma surgeons or the multidisciplinary team after implementation. However, following implementation of quality control management, there was a signifcant reduction in the
duration of basic diagnostics, time until receipt of laboratory data, time until frst computed tomography scan, time
until intubation, and time until an emergency operation (P<0.05). The deaths were caused by severe head injury (PRE:
5.4%, POST: 4%), hemorrhagic shock (PRE: 2.4%, POST: 0.7%), multiple-organ failure (PRE: 1.0%, POST: 0.3%), or other
causes (PRE: 0.7%, POST: 0.0%). The 72-h mortality decreased after the implementation of quality control management
(PRE vs. POST groups: 9.4 vs. 5.0%, P=0.04).
Conclusions: The implementation of quality control management resulted in decreased time to critical interventions, improved patient care efciency, and reduced early mortality. We recommend that this approach be replicated
at other trauma centers in China.
Creator
Zhe Du and Tianbing Wang
Publisher
BMC Emergency Medicine
Date
(2022) 22:34
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Zhe Du and Tianbing Wang, “Efect of implementing quality control management in the treatment of severely injured patients: a retrospective cohort study in a level I trauma center in China,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/3944.