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Trauma emergency unit: long-term evaluation of a quality assurance programme
E Gagneux1, P Lombrail, P Vichard
1Hôpital Jean Minjoz, Besancon Cedex, France.
Quality in Health Care : QHC
|February 6, 1998
Summary
A quality assurance program significantly reduced near adverse events in an orthopedic unit, demonstrating its effectiveness. Continuous quality improvement requires management principles and unit specialization for successful implementation.
Area of Science:
- Healthcare Quality Improvement
- Patient Safety
- Medical Auditing
Background:
- Quality assurance programs are crucial for evaluating and enhancing healthcare services.
- Previous assessments in 1993 identified areas for improvement in patient care processes.
Purpose of the Study:
- To conduct a long-term evaluation of a quality assurance program's effectiveness.
- To assess changes in near adverse events following the implementation of quality improvement initiatives.
Main Methods:
- Retrospective review of 1187 consecutive ambulatory patient medical records from July 1995.
- Analysis focused on the occurrence of near adverse events (potential harm events).
- Study conducted in the emergency area of an orthopedic, trauma, and plastic surgery unit at a French teaching hospital.
Main Results:
- A significant decrease in the rate of near adverse events was observed, from 9.9% in 1993 to 5.9% in 1995.
- 71 near adverse events were identified in 1995, representing 5.9% of ambulatory visits.
- A significant shift in the proportion of adverse event categories was noted, with fewer departures from prevention protocols.
Conclusions:
- Quality assurance programs are effective and valuable for healthcare settings, despite limitations.
- Sustained quality improvement necessitates principles of total quality management and a specialized unit structure.
- Quality assurance serves as a foundational step for implementing broader total quality management initiatives.