Building Capacity for Trauma Quality Improvement: An Innovative Pilot Program in Cameroon to Address the Burden of Injury

项目摘要/摘要 随着伤害成为低收入和中等收入环境中日益重要的公共卫生优先事项， 包括撒哈拉以南非洲(SSA)，制定改进的适合背景的方法 缺乏创伤护理系统。虽然已经在SSA创建了几个飞行员创伤登记， 使用登记数据进行伤害控制干预的相关程序，如创伤质量改进(QI)、 都是迫切需要的。在没有适当的方法的情况下，SSA中的创伤登记和其他监测工具 将仍然无力创造可采取行动的改变。喀麦隆似乎比其他国家受伤病的影响更大 该地区的国家。我们的长期目标是减少喀麦隆和其他地区受伤的影响 SSA通过开发一个综合创伤系统，创伤QI是其中的一个关键组成部分。整体而言 此应用程序的目标是通过开发创伤QI，在现有的集中式创伤登记的基础上构建 方法适用于喀麦隆的情况，并可推广到其他类似的SSA环境，即 实现我们长期目标的下一步。使用创伤登记来开发QI流程和 干预措施将为改善患者护理提供直接机制，并将输出到其他类似的 针对非传染性疾病或伤害控制的SSA设置和其他卫生系统。要完成以下任务 这项申请的目标，我们将追求四个具体目标：1)建立和培训同行驱动的创伤护理 喀麦隆的齐委员会，可以进行全面的案件审查和根本原因分析，以确定 具体可纠正的缺陷；2)培训四名“QI研究员”和一名QI项目经理，以开发研究和 具备QI方法论、监控和评估方面的分析技能；3)应用QI流程来改进现有的 创伤登记数据收集工具，增强其捕捉临床护理质量变化的能力 交付；以及4)召开QI委员会会议，提出适合具体情况的创伤QI干预措施 今后将在喀麦隆和类似环境中实施。这一贡献将创造出新颖的、与当地相关的 可在喀麦隆实施的创伤QI方法和适合具体情况的治疗战略 与其他SSA国家合作，改善创伤护理和伤情控制的预期结果。这些QI方法 治疗策略将成为如何使用创伤登记数据和QI方法的“路线图” 通过针对性、循证和情景的可操作干预措施改善临床创伤护理- 恰如其分。一个与文化相关的、同行驱动的全面QI过程的发展是新颖的。 我们的方法是在QI过程中对临床医生进行培训，并采用科学的方法 进行QI分析。这项研究倡议是朝着最终创建一个核心小组的关键一步 具有传播QI过程的技能的临床科学家，并开发了一个个人网络，这些人 可以在护理伤员方面创造一种以研究为基础的改进文化。

Project Summary/Abstract As injuries become an increasingly important public health priority in low- and middle-income settings, including sub-Saharan Africa (SSA), context-appropriate methodologies for developing improvements in systems of trauma care are lacking. Although several pilot trauma registries have been created in SSA, correlative processes to use registry data for injury control interventions, like trauma quality improvement (QI), are urgently needed. Without appropriate methodology, trauma registries and other surveillance tools in SSA will remain powerless to create actionable change. Cameroon appears to be more affected by injury than other countries in the region. Our long-term goal is to reduce the impact of injury in Cameroon and other parts of SSA through development of an integrated trauma system, of which trauma QI is a key component. The overall objective of this application is to build on an existing centralized trauma registry by developing trauma QI methodology appropriate for the Cameroonian context and generalizable to other similar SSA settings, which is the next step toward attainment of our long-term goal. Using trauma registries to develop QI processes and interventions will provide a direct mechanism for improved patient care that will be exportable to other similar SSA settings and other health systems for non-communicable diseases or injury control. To accomplish the objective of this application, we will pursue four specific aims: 1) Establish and train a peer-driven trauma care QI committee in Cameroon that can perform comprehensive case review and root cause analysis to identify specific correctable deficiencies; 2) Train four “QI fellows” and a QI program manager to develop research and analytic skills in QI methodology, monitoring, and evaluation; 3) Apply the QI process to refine the existing trauma registry data collection tool, enhancing its capacity to capture changes in the quality of clinical care delivery; and 4) Implement QI committee meetings to propose context-appropriate trauma QI interventions for future implementation in Cameroon and similar settings. This contribution will create novel, locally-relevant trauma QI methods and context-appropriate treatment strategies that can be implemented in Cameroon and other SSA countries with the expected result of improving trauma care and injury control. These QI methods and treatment strategies will serve as a “roadmap” for how to use trauma registry data and QI methodology to improve clinical trauma care through actionable interventions that are targeted, evidence-based, and context- appropriate. The development of a culturally-relevant, peer-driven comprehensive QI process is novel. Embedded in our approach is the training of clinicians in the process of QI and the scientific methods by which to conduct QI analysis. This research initiative is the vital step towards ultimately creating a core group of clinician scientists with the skills to disseminate the QI process, and developing a network of individuals who can create a culture of research-based improvements in the care of the injured.