Effect of implementing quality control management in the treatment of severely injured patients: a retrospective cohort study in a level I trauma center in China.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968543 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-227X (Electronic) Linking ISSN: 1471227X NLM ISO Abbreviation: BMC Emerg Med Subsets: MEDLINE

Original Publication: London : BioMed Central, [2001-

Trauma Centers* ; Wounds and Injuries*/therapy; Female ; Hospitalization ; Humans ; Injury Severity Score ; Male ; Quality Control ; Retrospective Studies

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 stratified 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 differences 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 significant reduction in the duration of basic diagnostics, time until receipt of laboratory data, time until first 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 efficiency, and reduced early mortality. We recommend that this approach be replicated at other trauma centers in China.
(© 2022. The Author(s).)

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Keywords: Emergency operation; Mortality; Multidisciplinary team; Quality control management; Severe trauma

Date Created: 20220306 Date Completed: 20220502 Latest Revision: 20220502

20240513

PMC8897735

10.1186/s12873-022-00595-8

35247973