Development and evaluation of evidence-informed quality indicators for adult injury care

Maria J. Santana, Henry T. Stelfox, Mark Asbridge, Chad G. Ball, Peter Cameron, Dianne Dyer, Claire Marie Fortin, Louis Hugo Francescutti, Kenneth M. Jaffe, Andrew W. Kirkpatrick, Karen Kmetik, John Kortbeek, Lynne Moore, Avery Nathens, Thomas Noseworthy, Nicolas Phan, Frederick Rivara, Bryan Singleton, Sharon Straus, Marc SwiontkowskiJohn Tallon, Andrew Travers, David Zygun

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

OBJECTIVE: To develop and evaluate evidence-informed quality indicators of adult injury care. BACKGROUND: Injury is a leading cause of morbidity and mortality, but there is a lack of consensus regarding how to evaluate injury care. METHODS: Using a modification of the RAND/UCLA Appropriateness Methodology, a panel of 19 injury and quality of care experts serially rated and revised quality indicators identified from a systematic review of the literature and international audit of trauma center quality improvement practices. The quality indicators developed by the panel were sent to 133 verified trauma centers in the United States, Canada, Australia, and New Zealand for evaluation. RESULTS: A total of 84 quality indicators were rated and revised by the expert panel over 4 rounds of review producing 31 quality indicators of structure (n = 5), process (n = 21), and outcome (n = 5), designed to assess the safety (n = 8), effectiveness (n = 17), efficiency (n = 6), timeliness (n = 16), equity (n = 2), and patient-centeredness (n = 1) of injury care spanning prehospital (n = 8), hospital (n = 19), and posthospital (n = 2) care and secondary injury prevention (n = 1). A total of 101 trauma centers (76% response rate) rated the indicators (1 = strong disagreement, 9 = strong agreement) as targeting important health improvements (median score 9, interquartile range [IQR] 8-9), easy to interpret (median score 8, IQR 8-9), easy to implement (median score 8, IQR 7-8), and globally good indicators (median score 8, IQR 8-9). CONCLUSIONS: Thirty-one evidence-informed quality indicators of adult injury care were developed, shown to have content validity, and can be used as performance measures to guide injury care quality improvement practices.

Original languageEnglish (US)
Pages (from-to)186-192
Number of pages7
JournalAnnals of surgery
Volume259
Issue number1
DOIs
StatePublished - Jan 1 2014

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    Santana, M. J., Stelfox, H. T., Asbridge, M., Ball, C. G., Cameron, P., Dyer, D., Fortin, C. M., Francescutti, L. H., Jaffe, K. M., Kirkpatrick, A. W., Kmetik, K., Kortbeek, J., Moore, L., Nathens, A., Noseworthy, T., Phan, N., Rivara, F., Singleton, B., Straus, S., ... Zygun, D. (2014). Development and evaluation of evidence-informed quality indicators for adult injury care. Annals of surgery, 259(1), 186-192. https://doi.org/10.1097/SLA.0b013e31828df98e