Abstract text (incl. references and figure legends)
Introduction
Unwarranted variation is the enemy of quality. New Zealand has previously observed high rates of death and variation in outcomes across the country. Investment in quality improvement has been prioritised to address this variation
Materials and methods
The population-based national registry provides a source of information on everyone who meets the threshold for major trauma. Initial work focussed on the patterns of injury, process indicators, and death as the sole measure of patient outcome. The system has evolved to include PROMs (Patient Reported Outcome Measures), and rehabilitation data to inform outcomes post-discharge from hospital. Quality Improvement focus has prioritised three areas: critical haemorrhage, traumatic brain injury, and rehabilitation. Approaches such as collaboratives and bundles of care have been a useful addition to more traditional approaches such as guidelines and policy.
Results
Approximately 2,500 people suffer major trauma each year, with an incidence rate of 52/100,000. Case fatality rate has reduced from 12% to 7.3% since 2015. Process of care are observed with more patients being transported to definitive care hospital from scene, and an increase in trauma calls and tertiary survey. DALY"s have decreased, and there is a notable reduction in the insurance costs associated with working people who have been seriously injured. There is minimal variation in outcomes and processes between regions.
Conclusion
An organised quality improvement program is an important component of contemporary trauma care. A focus on all aspects of the patient journey from pre-hospital, hospital and rehabilitation is important for systems to have oversight of. The key benefit is improvement in patient outcomes measured by death and improved rehabilitation for those that survive.
Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)
No