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Priorities for trauma quality improvement and registry use in Australia and New Zealand

  • Kate Curtis
    Correspondence
    Corresponding author at: 88 Mallett Street - Building A, The University of Sydney, Camperdown, NSW 2050 Australia.
    Affiliations
    The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Australia

    Royal Australasian College of Surgeons, Trauma Quality Improvement Sub-Committee

    Australasian Trauma Society

    Australian Trauma Quality Improvement Program (AusTQIP), Australia

    Illawarra Shoalhaven Local Health District, NSW, Australia

    University of Wollongong, Faculty of Science, Medicine and Health, Australia
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  • Belinda Gabbe
    Affiliations
    Royal Australasian College of Surgeons, Trauma Quality Improvement Sub-Committee

    Australasian Trauma Society

    Monash University, School of Public Health and Preventive Medicine, Australia
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  • Ramon Z. Shaban
    Affiliations
    The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Australia

    Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Camperdown, NSW, Australia

    Centre for Infectious Diseases and Microbiology and the Directorate of Nursing, Midwifery and Clinical Governance, Western Sydney Local Health District, Westmead, NSW, Australia
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  • Shizar Nahidi
    Affiliations
    The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Australia
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  • Cliff Pollard AM
    Affiliations
    Royal Australasian College of Surgeons, Trauma Quality Improvement Sub-Committee

    Australasian Trauma Society
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  • Kirsten Vallmuur
    Affiliations
    Australian Trauma Quality Improvement Program (AusTQIP), Australia

    Jamieson Trauma Institute, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Queensland Health, Australia
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  • Katherine Martin
    Affiliations
    Royal Australasian College of Surgeons, Trauma Quality Improvement Sub-Committee

    Australasian Trauma Society

    Trauma Service, Alfred Hospital, Victoria, Australia
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  • Grant Christey
    Affiliations
    Royal Australasian College of Surgeons, Trauma Quality Improvement Sub-Committee

    Australasian Trauma Society

    Australian Trauma Quality Improvement Program (AusTQIP), Australia

    Waikato District Health Board, Hamilton, New Zealand

    Waikato Clinical School, University of Auckland, New Zealand
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Published:September 25, 2019DOI:https://doi.org/10.1016/j.injury.2019.09.033

      Highlights

      • Perspectives of trauma care professionals in Australia and New Zealand about the use of the trauma registry data are presented.
      • The key priorities in the trauma quality improvement are identified through an exploratory survey of trauma professionals.
      • Trauma registry data are under-utilised in Australia and New Zealand.
      • Using trauma registry data is fundamental to drive clinical improvement and system/process improvement in Australia and New Zealand.
      • The findings will support the strategic activities of the Royal Australasian College of Surgeons Trauma Quality Improvement Subcommittee and contribute to the strategies of key organisations that are responsible for improving trauma care in Australia and New Zealand.

      Abstract

      Introduction

      The Australia New Zealand Trauma Registry enables the collection and analysis of standardised data about trauma patients and their care for quality improvement, injury prevention and benchmarking. Little is known, however, about the needs of providers and clinicians in relation to these data, or their views on trauma quality improvement priorities. As clinical experts, trauma clinicians should have input to these as ultimately their practice may be influenced by report findings. This paper presents the perspectives of multidisciplinary trauma care professionals in Australia and New Zealand about the use of the Australia New Zealand Trauma Registry data and trauma quality improvement priorities.

      Methods

      An exploratory survey of trauma professionals from relevant Australia and New Zealand professional organisations was conducted using the Snowballing Method between September 2018 and February 2019. Participants were recruited via a non-random sampling technique to complete an online survey. Descriptive statistical and content analyses were conducted.

      Results

      The data use priorities identified by 102 trauma professionals from a range of locations participated were clinical improvement and system/process improvement (86.3%). Participants reported that access to trauma data should primarily be for clinicians (93.1%) and researchers (87.3%). Having a standardised approach to review trauma cases across hospitals was a priority in trauma quality improvement.

      Conclusion

      Trauma registry data are under-utilised and their use to drive clinical improvement and system/process improvement is fundamental to trauma quality improvement in Australia and New Zealand.

      Keywords

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      References

        • Leonard E.
        • Curtis K.
        Are Australian and New Zealand trauma service resources reflective of the Australasian trauma verification model resource criteria?.
        ANZ J Surg. 2014; 84: 523-527https://doi.org/10.1111/ans.12381
        • Royal Australasian College of Surgeons
        Trauma verification kangaroo point.
        Royal Australasian College of Surgeons, Queensland2018 ([cited 2018 11 July]. Available from)
        • Fitzgerald M.C.
        • Curtis K.
        • Cameron P.A.
        • Ford J.E.
        • Howard T.S.
        • Crozier J.A.
        • et al.
        The Australian trauma registry.
        ANZ J Surg. 2018; 89 (Epub 2018/12/15PubMed PMID:30548382): 286-290https://doi.org/10.1111/ans.14940
        • Isles S.
        • Christey G.
        • Civil I.
        • Hicks P.
        The New Zealand major trauma registry: the foundation for a data-driven approach in a contemporary trauma system.
        N Zea Med J. 2017; 130: 19-27
        • Palmer C.S.
        • Davey T.M.
        • Mok M.T.
        Standardising trauma monitoring: the development of a minimum dataset for trauma registries in Australia and New Zealand.
        Injury. 2012; 44: 834-841https://doi.org/10.1016/j.injury.2012.11.022
        • Gruen R.
        • Gabbe B.
        • Stelfox H.
        • Cameron P.
        Indicators of the quality of trauma care and the performance of trauma systems.
        Br J Surg. 2012; 99: 97-104
      1. Australian Trauma Quality Improvement (AusTQIP) Collaboration. Australian trauma registry, Management of the Severely Injured in Australia, 1 July 2016 to 30 June 2017. Melbourne, Victoria: 2018.

        • Isles S.
        • Civil I.
        New Zealand major trauma registry & national clinical network.
        2018 (New Zealand)
        • Stelfox H.T.
        • Khandwala F.
        • Kirkpatrick A.W.
        • Santana M.J.
        Trauma center volume and quality improvement programs.
        J Trauma Acute Care Surg. 2012; 72 (Epub 2012/04/12PubMed PMID:22491612): 962-967https://doi.org/10.1097/TA.0b013e31824a7bd8
        • NSW Institute of Trauma and Injury Management
        Trauma patient outcome evaluation.
        NSW Agency for Clinical Innovation, Sydney2016
      2. The Royal Australasian College of Surgeons. About RACS [cited 2019 16 April]. Available from: https://www.surgeons.org/about/.

      3. Australasian Trauma Society. About the Australasian trauma society [cited 2019 16 april]. Available from: https://www.traumasociety.com.au/about-us/.

        • Naderifar M.
        • Goli H.
        • Ghaljaie F.
        Snowball sampling: a purposeful method of sampling in qualitative research.
        SDMEJ. 2017; 14: e67670
        • Sedgwick P.
        Snowball sampling.
        BMJ. 2013; 347: f7511
        • Harris P.A.
        • Taylor R.
        • Thielke R.
        • Payne J.
        • Gonzalez N.
        • Conde J.G.
        Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support.
        J Biomed Inform. 2009; 42: 377-381
      4. Royal Australasian College of Surgeons. Trauma subcommittees terms of reference. Trauma Quality Improvement Sub-committee. Ref. No. FES-FEL-019.

        • StataCorp
        Stata statistical software: release 14.
        StataCorp LP, College Station, TX2015
        • Hsieh H.-.F.
        • Shannon S.E.
        Three approaches to qualitative content analysis.
        Qual Health Res. 2005; 15: 1277-1288
        • McNeil J.J.
        • Evans S.M.
        • Johnson N.P.
        • Cameron P.A.
        Clinical-quality registries: their role in quality improvement.
        Med. J. Aust. 2010; 192 (Epub 2010/03/06. PubMed PMID20201755): 244-245
        • The Australian Commission on Safety and Quality in Health Care
        Economic evaluation of clinical quality registries.
        ACSQHC, Sydney2016
      5. ANZHFR. Bi-National Annual Report of Hip Fracture Care 2018 Contract No.: ISBN-13: 978-0-7334-3824-0.

        • World Health Organization
        Guidelines for trauma quality improvement programmes.
        2009 (Geneva)
        • Amalberti R.
        • Benhamou D.
        • Auroy Y.
        • Degos L.
        Adverse events in medicine: easy to count, complicated to understand, and complex to prevent.
        J Biomed Inform. 2011; 44 (Epub 2009/07/21PubMed PMID19615466): 390-394https://doi.org/10.1016/j.jbi.2009.06.004
        • Gabbe B.J.
        • Simpson P.M.
        • Cameron P.A.
        • Ponsford J.
        • Lyons R.A.
        • Collie A.
        • et al.
        Long-term health status and trajectories of seriously injured patients: a population-based longitudinal study.
        PLoS Med. 2017; 14 (Epub 2017/07/06PubMed PMID28678814PubMed Central PMCIDPMCPMC5497942)e1002322https://doi.org/10.1371/journal.pmed.1002322