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Trauma Quality Indicators

Background:

From the time a trauma patient is picked up by EMS on scene through the patient's initial assessment, hospital course, and discharge, our trauma program is carefully monitoring each patient and collecting data. Data collected includes demographic information, injury information, prehospital and hospital information, past medical history, traumatic injuries, in-hospital events and outcomes. Data is entered into our trauma registry and analyzed regularly through various performance improvement programs to ensure the trauma service is providing high quality care to each patient. 

Much of the data collected for the registry is gathered by trauma registrars doing extensive chart reviews and depends greatly on complete and accurate documentation from our trauma providers. While we should be practicing complete and accurate documentation as part of being a good healthcare provider, it is also essential for our trauma program to able to monitor and analyze the care of our trauma patients to ensure that high quality care is provided and patient outcomes are optimized. 

Pre-Existing Conditions

Several pre-existing conditions are captured in the trauma registry that help us risk stratify patients for observed and expected outcomes. These pre-existing conditions should be documented in the Trauma H&P and/or the Trauma Tertiary Survey as well as added to the patient's problem list in the electronic medical record. 

The pre-existing conditions captured in the trauma registry are as follows:

  1. advanced directive limiting care
  2. alcohol use disorder
  3. anticoagulant therapy
  4. attention deficit disorder/attention deficit hyperactivity disorder (ADD/ADHD)
  5. Bipolar I/II disorder
  6. Bleeding disorder
  7. Cerebral vascular accident (CVA)
  8. Chronic obstructive pulmonary disease (COPD)
  9. Chronic renal failure
  10. Cirrhosis
  11. Congenital anomalies 
  12. Congestive heart failure (CHF)
  13. Current smoker
  14. Currently receiving chemotherapy for cancer
  15. Dementia
  16. Diabetes mellitus
  17. Disseminated cancer
  18. Functionally dependent health status
  19. Hypertension
  20. Major depressive disorder 
  21. Myocardial infarction (MI)
  22. Other mental/personality disorders 
  23. Peripheral arterial disease (PAD)
  24. Post-traumatic stress disorder (PTSD)
  25. Pregnancy
  26. Prematurity 
  27. Schizoaffective disorder
  28. Schizophrenia
  29. Steroid use
  30. Substance use disorder 

Hospital Events

Events reviewed through our performance improvement program include the following:

  1. Acute Kidney Injury (AKI)
  2. Acute Respiratory Distress Syndrome (ARDS)
  3. Alcohol withdrawal syndrome
  4. Cardiac arrest with CPR
  5. Catheter-associated urinary tract infection (CAUTI)
  6. Central line-associated blood stream infection (CLABSI)
  7. Deep surgical sight infection
  8. Deep vein thrombosis (DVT)
  9. Delirium
  10. Myocardial infarction (MI)
  11. Organ/space surgical site infection
  12. Osteomyelitis 
  13. Pressure ulcer
  14. Pulmonary embolism (PE)
  15. Severe sepsis
  16. Stroke/CVA
  17. Superficial surgical site infection 
  18. Unplanned admission to the ICU
  19. Unplanned intubation
  20. Unplanned visit to the operating room
  21. Ventilator-associated pneumonia (VAP)

If you are caring for a trauma patient that experiences one of the above stated hospital events, please notify our trauma program/performance improvement coordinators at [email protected].

 

 

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