The Development for Quality of Inclusive Trauma Care, Khon Kaen Regional Hospital-การพัฒนาคุณภาพการรักษาพยาบาลผู้ป่วยอุบัติเหตุ โรงพยาบาลศูนย์ขอนแก่น

Abstract

          Trauma management system is complicated and critical. Many stations have to be involved in the system. Any pitfalls at any station of the management system may result in mortality or morbidity. This participatory action research was to develop the quality improvement program in trauma care for the patients visiting Khon Kaen regional hospital. Dividing into 3 phases, it was conducted in the first cycle during 1994-1995, second cycle 1997-1998, third cycle 2000-2001. Khon Kaen Regional Hospital had set up the Trauma Audit Committee to develop the quality improvement program in trauma care for the patients visiting Khon Kaen Regional Hospital. Detailed activities in each cycle of development composed of 5 components. 1. Identify problem: setting up the evaluating system of the trauma patients by grading the severity of injury using TRISS Methodology integrating into trauma registry. 2. Understand cause: the Trauma Audit Committee studied causes and pitfalls in the trauma care system of all trauma deaths in every cycle of the studies by using the process of peer group review. 3. Suggest solution: developing trauma audit and key performance indicator for trauma care. 4. Implement: integrating trauma audit and performance indicators in the hospital trauma care system including solving the correctable problems in system inadequacy. 5. Evaluate: running the evaluation program as in the 1st step. Results from the evaluation of step5th would be the input for a next cycle of the quality improvement program. According to the process of quality improvement program using concept of participatory action research, preventable death rate study by peer group review was reduced from 3.2 percent in 1994 to 1.3 percent in 2000. Pitfalls in the process of trauma care were also reduced from 407 points to 156 and reduction of pitfalls that contribute to mortality from 296 points to 88. In conclusion, though the process of trauma care of the critically injured patients ware complicated but to develop the quality improvement program using the concept of participatory action research was possible. With the strong and intensive quality improvement program resulted in better quality care for the patients visiting the hospital. There were continuing reductions in mortality in every severity group.

Key words: trauma patients, trauma care audit, TRISS methodology