Table 2 Quality indicator use according to teaching status †
Quality indicators | Teaching (%) | Non-teaching (%) | Chi-square |
|---|---|---|---|
P-value | |||
Trauma centres measuring quality indicators | 173 (99) | 72 (97) | 0.37 |
No. quality indicators | |||
Total | 5557 | 2934 | |
Median number per centre (IQR) | 26 (14,38) | 21.5 (10–43.5) | p = 0.556* |
Donabedian dimensions of care evaluated by quality indicators | |||
Structure | 45 (0.008) | 27 (0.009) | 0.96 |
Process | 3696 (67) | 2027 (69) | 0.02 |
Outcome | 1825 (33) | 889 (30) | 0.02 |
Content of the quality indicators** | |||
Medical error or adverse event (e.g. decubitus ulcer rate) | 1829 (33) | 913 (31) | 0.09 |
Treatment (e.g. time to treatment of joint dislocation) | 1013 (18) | 413 (14) | <0.001 |
Triage & patient flow (e.g. field triage rate) | 823 (15) | 539 (18) | <0.001 |
Documentation (e.g. invasive prehospital procedure documentation rate) | 561 (10) | 357 (12) | 0.003 |
Clinician(s) (e.g. trauma team activation for all major injuries) | 335 (6.0) | 190 (6.5) | 0.42 |
Morbidity & mortality (e.g. hospital mortality rate) | 255 (4.4) | 139 (4.7) | 0.76 |
Diagnostic studies & patient monitoring (e.g. time to CT scan) | 269 (4.8) | 122 (4.2) | 0.15 |
Pre-hospital times (e.g. scene time) | 192 (3.5) | 107 (3.6) | 0.65 |
Other (e.g. attendance at morbidity and mortality rounds) | 134 (2.4) | 90 (3.1) | 0.07 |
IOM dimensions of care evaluated by quality indicators** | |||
Safe (e.g. rate of unplanned intensive care unit admissions) | 2667 (48) | 1441 (49) | 0.33 |
Effective (e.g. rate of deep vein thrombosis prophylaxis) | 1733 (31) | 973 (33) | 0.06 |
Patient-Centred (e.g. acute pain management for all injured patients) | 33 (0.59) | 16 (0.55) | 0.78 |
Timely (e.g. time to acute subdural hematoma evacuation) | 1302 (23) | 577 (20) | <0.001 |
Efficient (e.g. field triage rate) | 1395 (25) | 879 (30) | <0.001 |
Equitable (e.g. deaths referred for potential organ donation) | 1 (0.018) | 0 (0) | 0.47 |