Implementation of the World Health Organization Trauma Care Checklist Program in 11 Centers Across Multiple Economic Strata: Effect on Care Process Measures

被引：58

作者：

Lashoher, Angela ^{[1
]}

Schneider, Eric B. ^{[2
,3
]}

Juillard, Catherine ^{[4
]}

Stevens, Kent ^{[5
]}

Colantuoni, Elizabeth ^{[6
]}

Berry, William R. ^{[7
]}

Bloem, Christina ^{[8
]}

Chadbunchachai, Witaya ^{[9
]}

Dharap, Satish ^{[10
]}

Dy, Sydney M. ^{[11
]}

Dziekan, Gerald ^{[12
]}

Gruen, Russell L. ^{[13
]}

Henry, Jaymie A. ^{[14
]}

Huwer, Christina ^{[15
]}

Joshipura, Manjul ^{[16
]}

Kelley, Edward ^{[17
]}

Krug, Etienne ^{[18
]}

Kumar, Vineet ^{[19
]}

Kyamanywa, Patrick ^{[20
]}

Mefire, Alain Chichom ^{[21
]}

Musafir, Marcos ^{[22
]}

Nathens, Avery B. ^{[23
,24
]}

Ngendahayo, Edouard ^{[25
]}

Thai Son Nguyen ^{[26
]}

Roy, Nobhojit ^{[27
]}

Pronovost, Peter J. ^{[28
]}

Khan, Irum Qumar ^{[29
]}

Razzak, Junaid Abdul ^{[30
,31
]}

Rubiano, Andres M. ^{[32
]}

Turner, James A. ^{[33
]}

Varghese, Mathew ^{[34
]}

Zakirova, Rimma ^{[35
]}

Mock, Charles ^{[36
]}

机构：

[1] 14 Chemin Contamine, F-01420 Chanay, France

[2] Harvard Med Sch, Brigham & Womens Hosp, Ctr Surg & Publ Hlth, 1620 Tremont St,Suite 4-020, Boston, MA 02120 USA

[3] Johns Hopkins Sch Med, Johns Hopkins Surg Ctr Outcomes Res, Baltimore, MD 21205 USA

[4] Univ Calif San Francisco, Dept Surg, Ctr Global Surg Studies, 1001 Potrero Ave,3A, San Francisco, CA 94110 USA

[5] Johns Hopkins Sch Med, 1800 Orleans St,Suite 6107E, Baltimore, MD 21287 USA

[6] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Biostat, 615 N Wolfe St, Baltimore, MD 21205 USA

[7] Harvard Sch Publ Hlth, Dept Hlth Policy & Management, 401 Pk Dr, Boston, MA 02215 USA

[8] Suny Downstate Med Ctr, Dept Emergency Med, 450 Clarkson Ave,Box 1228, Brooklyn, NY 11203 USA

[9] Khon Kaen Hosp, WHO Collaborating Ctr Injury Prevent & Safety Pro, Khon Kaen 40000, Thailand

[10] Lokmanya Tilak Municipal Med Coll & Gen Hosp, Dept Surg, Bombay 400022, Maharashtra, India

[11] Johns Hopkins Bloomberg Sch Publ Hlth, Rm 609,624 N Broadway, Baltimore, MD 21205 USA

[12] World Self Medicat Ind, Rue Cossonay 5,Case Postale 124, CH-1023 Crissier, Switzerland

[13] Nanyang Technol Univ, Lee Kong Chian Sch Med, Res Techno Plaza,02-07,50 Nanyang Dr, Singapore 637553, Singapore

[14] Univ Chicago, Dept Surg, 5841 S Maryland Ave, Chicago, IL 60637 USA

[15] Unfallkrankenhaus Berlin, Clin Trauma Surg & Orthoped, Warener Str 7, D-12683 Berlin, Germany

[16] Acad Traumatol, 504 Sangita Complex, Parimal Garden 380015, Ahmadabad, India

[17] WHO, Serv Delivery & Safety Dept, 20 Ave Appia, CH-1211 Geneva, Switzerland

[18] WHO, Dept Management NCDs Disabil Violence & Injury Pr, 20 Ave Appia, CH-1211 Geneva, Switzerland

[19] Lokmanya Tilak Municipal Med Coll & Gen Hosp, Dept Surg, Coll Bldg,First Floor, Bombay 400022, Maharashtra, India

[20] Univ Rwanda, Sch Med & Pharm, Coll Med & Hlth Sci, Nyarugenge Campus,POB 3286, Kigali, Rwanda

[21] Univ Buea & Reg Hosp Limbe, Fac Hlth Sci, POB 25526, Yaounde, Cameroon

[22] Univ Fed Rio de Janeiro, Rua Voluntarios Patria,445 SL 201, BR-22270005 Rio De Janeiro, Brazil

[23] Univ Toronto, Dept Surg, 2075 Bayview Ave,Room D5 74, Toronto, ON M4N 3M5, Canada

[24] Sunnybrook Hlth Sci Ctr, 2075 Bayview Ave,Room D5 74, Toronto, ON M4N 3M5, Canada

[25] Univ Teaching Hosp Kigali, POB 2534, Kigali, Rwanda

[26] Duc Giang Gen Hosp, 54 Truong Lam, Hanoi, Vietnam

[27] HBNI Univ, Govt India, BARC Hosp, Dept Surg, Anushaktinagar, Bombay 400094, Maharashtra, India

[28] Johns Hopkins Med, 600 N Wolfe St,CMSC 131, Baltimore, MD 21287 USA

[29] Aga Khan Univ, Dept Emergency Med, 1st Floor,Stadium Rd,POB 3500, Karachi 74800, Pakistan

[30] Johns Hopkins Univ, Sch Med, 5801 Smith Ave,Ste 220, Baltimore, MD 21219 USA

[31] Aga Khan Univ, Karachi, Pakistan

[32] Neiva Univ Hosp, MEDITECH Fdn, Calle 5 11-19, Huila, Neiva, Colombia

[33] Sick Kids Hosp, Dept Paedeatr Orthoped, 555 Univ Ave, Toronto, ON M5G 1X8, Canada

[34] St Stephens Hosp, Dept Orthopaed, Delhi 110054, India

[35] Univ Toronto, St Michaels Hosp, 30 Bond St, Toronto, ON M5B 1W8, Canada

[36] Univ Washington, HIPRC, Harborview Med Ctr, Dept Surg, 325 Ninth Ave,Box 359960, Seattle, WA 98104 USA

来源：

WORLD JOURNAL OF SURGERY | 2017年 / 41卷 / 04期

关键词：

SAFETY; ERRORS; MORTALITY; ACCIDENT; INFECTIONS; MORBIDITY; EMERGENCY; INJURIES; SYSTEM;

D O I：

10.1007/s00268-016-3759-8

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Trauma contributes more than ten percent of the global burden of disease. Initial assessment and resuscitation of trauma patients often requires rapid diagnosis and management of multiple concurrent complex conditions, and errors are common. We investigated whether implementing a trauma care checklist would improve care for injured patients in low-, middle-, and high-income countries. From 2010 to 2012, the impact of the World Health Organization (WHO) Trauma Care Checklist program was assessed in 11 hospitals using a stepped wedge pre- and post-intervention comparison with randomly assigned intervention start dates. Study sites represented nine countries with diverse economic and geographic contexts. Primary end points were adherence to process of care measures; secondary data on morbidity and mortality were also collected. Multilevel logistic regression models examined differences in measures pre- versus post-intervention, accounting for patient age, gender, injury severity, and center-specific variability. Data were collected on 1641 patients before and 1781 after program implementation. Patient age (mean 34 +/- 18 vs. 34 +/- 18), sex (21 vs. 22 % female), and the proportion of patients with injury severity scores (ISS) >= 25 (10 vs. 10 %) were similar before and after checklist implementation (p > 0.05). Improvement was found for 18 of 19 process measures, including greater odds of having abdominal examination (OR 3.26), chest auscultation (OR 2.68), and distal pulse examination (OR 2.33) (all p < 0.05). These changes were robust to several sensitivity analyses. Implementation of the WHO Trauma Care Checklist was associated with substantial improvements in patient care process measures among a cohort of patients in diverse settings.

引用

页码：954 / 962

页数：9

共 28 条

[1]

Anderson DJ, 2014, INFECT CONT HOSP EP, V35, P605, DOI [10.1086/676022, 10.1017/S0899823X00193869]

[2]

[Anonymous], 2002, INJURY LEADING CAUSE

[3] Simulation-Based Trial of Surgical-Crisis Checklists [J].