The design, construction and implementation of a computerised trauma registry in a developing South African metropolitan trauma service

Laing, G L; Bruce, John; Aldous, Colleen; Clarke, Damian

doi:10.1016/j.injury.2013.05.013

Cited by 50 publications

(50 citation statements)

References 6 publications

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“…The Pietermaritzburg Metropolitan Trauma Service (PMTS) was established in 2006 with the intention of providing comprehensive trauma care to the city of Pietermaritzburg and the whole of the western part of the KwaZulu-Natal (KZN) province. [1][2][3][4] The PMTS aims to provide resources and expertise as well as strategic and political leadership in trauma care to the city of Pietermaritzburg and the western rural health districts of KZN. Pietermaritzburg is the capital of KZN and the largest city in the western part of the province.…”

mentioning

confidence: 99%

“…As part of a systematic quality improvement programme, the PMTS implemented an electronic surgical registry (ESR) in January 2012 and updated this system to a comprehensive hybrid electronic medical registry (HEMR) in January 2013 in Grey's Hospital. [1][2][3][4] This study used the data from our prospectively maintained ESR and HEMR to audit the incidence, spectrum and outcome of paediatric trauma managed by the PMTS.…”

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confidence: 99%

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The incidence, spectrum and outcome of paediatric trauma managed by the Pietermaritzburg Metropolitan Trauma Service

Manchev

Bruce

Oosthuizen

et al. 2015

annals

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The ESR has proved to be an effective surveillance system and has enabled the accurate quantification of the burden of paediatric trauma in Pietermaritzburg. This has improved our understanding of the mechanisms and patterns of injury, and has identified a high incidence of intentional and penetrating trauma as well as road traffic collisions. These data can be used to guide strategies to reduce the burden of paediatric trauma in our environment.

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mentioning

confidence: 99%

mentioning

confidence: 99%

The incidence, spectrum and outcome of paediatric trauma managed by the Pietermaritzburg Metropolitan Trauma Service

Manchev

Bruce

Oosthuizen

et al. 2015

annals

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“…[8,9] These systems were used to assess the quality of care in the area. [10][11][12][13][14][15] Once this situational analysis was done, I moved on to the stage of synthesis of strategies and interventions, introducing educational programmes and refinement of morbidity and mortality meetings with the intention of driving quality improvement; [16,17] a number of innovative registries, which allowed us to capture data for research and to quantify the burden of disease and the outcome more accurately; [18,19] use of the data from these registries to further inform morbidity and mortality meetings and educational initiatives; and a surgical outreach programme (that has run for over a decade), designed to uplift surgical care in the rural hospitals of western KwaZulu-Natal. [20] The grid structure helped in understanding the role of this latter programme and auditing its efficacy in transferring skills to the district hospitals.…”

Section: Applying the Grid To The Pietermaritzburg Metropolitan Traummentioning

confidence: 99%

“…[18] The design, construction and implementation of a computerised trauma registry in a developing SA metropolitan trauma service [19] Development, implementation and evaluation of a hybrid electronic medical record system specifically designed for a developing-world surgical service [20] Grid 5 Tick-box admission forms improve the quality of documentation of surgical emergencies, but have limited impact on clinical behaviour [21] The introduction of an acute physiological support service for surgical patients is an effective error reduction strategy [22] Grid 6 A multifaceted quality improvement programme results in improved outcomes for the selective nonoperative management of penetrating abdominal trauma in a developing world trauma centre [23] Challenges and merits of improving burn care in SA [24] Develop targeted quality improvement programmes Vision Quality metric Quality metric Quality metric Grid 1 represents projects analysing the inputs of care; Grid 2 represents projects analysing the process of care; Grid 3 represents projects analysing the outcomes of the process of care and the inputs of care; Grid 4 represents projects designed to improve the inputs of care; Grid 5 represents projects designed to improve the process of care; Grid 6 represents projects designed to measure the outcomes after inputs and processes have been improved.…”

Section: Gridmentioning

confidence: 99%

Trauma quality improvement: The Pietermaritzburg Metropolitan Trauma Service experience with the development of a comprehensive structure to facilitate quality improvement in rural trauma and acute care in KwaZulu-Natal, South Africa

Clarke¹

2015

S Afr Med J

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Strategic planning is a systematic process designed to assist organi sational decision-making by taking account of the micro environment(s) within an organisation, as well as the macroenvironment in which the organisation exists. [1][2][3][4][5] Healthcare systems are complex and tightly coupled. Strategic planning within such a system, without an overarching framework to provide a structure for quality improvement programmes, risks becoming ad hoc, haphazard, ineffectual and even counterproductive. The strategic planning process must identify the organisation's vision and mission or the system's aims and objectives. The mission statement explains the reasons for the healthcare system's existence. The vision statement identifies a potential more ideal 'future state' that the system aspires to achieve. Situational analysis follows and analyses the external environment to identify threats and opportunities, then looks inwards to assess the organisation's resources and capabilities. [1][2][3][4][5][6] The stage of synthesis follows, in which the strategic plan is crafted. The plan must then be implemented, and after that outcomes must be audited. There are a number of generic strategic planning tools that are of relevance to developing a structured systemic approach to quality improvement programmes. These include the SWOT analysis, the balanced scorecard, and strategic drift and gap analysis. SWOTThis acronym stands for Strengths, Weaknesses, Opportunities and Threats (SWOT) and identifies internal strengths and weaknesses, and threats and opportunities in the external environment, that may affect the organisation. The balanced scorecardThe balanced scorecard is a forward-looking management system that views the organisation from four perspectives, namely learning and growth, process, the customer point of view, and results. Strategic drift and gap analysisThe final outcome of a strategic plan is a result of the interaction of the external environment and three internal factors, namely the plan, the leadership and the culture of the organisation. A gap analysis model helps identify reasons for the strategic gap.

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“…Considering Brazilian data, there were 929,240 admissions to hospitals due to external causes and 141,227 deaths related to trauma. 1 For the 5-year period 2005 to 2009, external causes are the third leading cause of death in Brazil (12.57%), exceeded only by heart disease and cancer. 2 This prevalence is also observed in the international literature, but mainly because of the aging process of population and the increasing incidence of cancer, those disease tend to overcome the external causes.…”

Section: Introductionmentioning

confidence: 99%

Prehospital Trauma Care Registry Problems in South Brazil

Nasr¹,

Abreu²,

Collaço³

et al. 2014

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Background: Trauma registry remains a great problem to most countries that are implementing trauma systems. Nondigital data assessment and storage may lead to information deterioration along the process. In order to verify the missing registry in prehospital trauma rescuers' form, we ran this study. Study design:A prospective observational noncontrolled study with 288 random trauma cases brought to a Level 1 Trauma Center in Curitiba, between May 28th and June 10th 2006. We analyzed data registered in the prehospital rescue team form. The including criteria were all patients delivered to the trauma center by ambulances. The excluding criteria were patients not transported by ambulances and those without the proper form filled out. Statistical analysis was performed using the Chi-square for discrete, and the student's t-test for continuous variables.Results: Two hundred and eighty-eight trauma cases were observed. Twelve patients were excluded. Of the 276 patients who met the including criteria, 75% were men with a mean age of 27-year-old. In only 8.34% of times patients were brought by doctors, while in 91.66% by paramedics. 63.4% of patients were traffic injuries victims, followed by 12.31% falls, 6.52% falls from the high, 5.79% gunshot wounds, 5.34% assaults, 3.62% stab wounds, 2.89% others. Impressively, 16 patients (5.89%) had no records of respiratory rate from the prehospital care assessment, 20 (7.24%) had no data of systolic blood pressure and 13(4.71%)had no pulse registry. Furthermore, 31.25% of the RR not registered were abnormal in the hospital admission evaluation, as well as 15% of the SBPs, and 23% of HR. None of the cases had information regarding time from the scene to the hospital. Conclusion:Electronic data collection shall make checklists consistently filled out. It is not well understood the importance of registering data for most of healthcare providers working in the field, especially when they do not follow the in-hospital care of trauma patients.

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The design, construction and implementation of a computerised trauma registry in a developing South African metropolitan trauma service

Cited by 50 publications

References 6 publications

The incidence, spectrum and outcome of paediatric trauma managed by the Pietermaritzburg Metropolitan Trauma Service

The incidence, spectrum and outcome of paediatric trauma managed by the Pietermaritzburg Metropolitan Trauma Service

Trauma quality improvement: The Pietermaritzburg Metropolitan Trauma Service experience with the development of a comprehensive structure to facilitate quality improvement in rural trauma and acute care in KwaZulu-Natal, South Africa

Prehospital Trauma Care Registry Problems in South Brazil

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