An evaluation of provider-related and disease-related morbidity in a level I university trauma service: directions for quality improvement.

摘要: As the number of preventable trauma-related deaths plateaus as a result trauma system development, new directions for quality improvement in care must come from analyzing morbidity with standardized methods to establish thresholds provider-related and disease-specific complications. To such determine priorities improvements all patients who died, were admitted ICU or OR, hospitalized more than 3 days, interfacility transfers an academic service, concurrently evaluated 1 year. All complication events defined, reviewed, tabulated, classified using 135 categories These subdivided into provider-specific Provider-related complications justified unjustified allow identification potential improvement. A total 1108 (mean ISS, 17); there 97 deaths. Three potentially identified, 857 285 responsible errors 59 (21%). Disease-specific was primarily related infection; pneumonia accounted 36% infectious systemic infection only 8.6% Organ failure other major occurred 2%-8% patients. This type analysis forms basis on which hospital serves guide direct efforts toward continuous