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
Chaubey VP., Roberts DJ., Ferri MB., Bobrovitz NH., Stelfox HT.
Â© 2014 Chaubey et al. Full list of author information is available at the end of the articl Background: Although studies have suggested that a relationship exists between hospital teaching status an quality improvement activities, it is unknown whether this relationship exists for trauma centres Methods: We surveyed 249 adult trauma centres in the United States, Canada, Australia, and New Zealan (76% response rate) regarding their quality improvement programs. Trauma centres were stratified into two group (teaching [academic-based or affiliated] versus non-Teaching) and their quality improvement programs wer compared Results: All participating trauma centres reported using a trauma registry and measuring quality of care. Teaching centre were more likely than non-Teaching centres to use indicators whose content evaluated treatment (18% vs. 14%, p < 0.001 as well as the Institute of Medicine aim of timeliness of care (23% vs. 20%, p < 0.001). Non-Teaching centres were mor likely to use indicators whose content evaluated triage and patient flow (15% vs. 18%, p < 0.001) as well as the Institute o Medicine aim of efficiency of care (25% vs. 30%, p < 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 tw of these (in hospital mortality and appropriate admission physician/service) were used by over half of non-Teachin trauma centres. The majority of centres reported using morbidity and mortality conferences (96% vs. 97%, p = 0.61) an quality of care audits (94% vs. 88%, p = 0.08) while approximately half used report cards (51% vs. 43%, p = 0.22) Conclusions: Teaching and non-Teaching centres reported being engaged in quality improvement and exhibited largel similar quality improvement activities. However, differences exist in the type and frequency of quality indicators utilize among teaching versus non-Teaching trauma centres.