Evidence map›Paper›PMID 38772755›Full record

ArticleInjury2024

From targets to solutions: Implementing a trauma quality improvement bundle in Cameroon.

Dennis J Zheng, Mark T Yost, Lidwine N Mbuh, Mirene Tchekep, Jean Baptiste Boumsong, Jean Gustave Tsiagadigui, Rasheedat Oke, Catherine Juillard, Alain Chichom-Mefire, S Ariane Christie

Abstract read
In one paragraph

Article in Injury, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Dennis J ZhengProgram for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, 10833 Le Conte Ave, Suite 7V-111 CHS, Los Angeles, CA 90095, United States of America.
Mark T YostProgram for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, 10833 Le Conte Ave, Suite 7V-111 CHS, Los Angeles, CA 90095, United States of America. Electronic address: myost@mednet.ucla.edu.
Lidwine N MbuhUniversity of Buea, P.O. Box 63, Buea, Cameroon.
Mirene TchekepEdea Regional Referral Hospital, P.O. Box 100, Edea, Cameroon.
Jean Baptiste BoumsongEdea Regional Referral Hospital, P.O. Box 100, Edea, Cameroon.
Jean Gustave TsiagadiguiEdea Regional Referral Hospital, P.O. Box 100, Edea, Cameroon.
Rasheedat OkeProgram for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, 10833 Le Conte Ave, Suite 7V-111 CHS, Los Angeles, CA 90095, United States of America.
Catherine JuillardProgram for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, 10833 Le Conte Ave, Suite 7V-111 CHS, Los Angeles, CA 90095, United States of America.
Alain Chichom-MefireUniversity of Buea, P.O. Box 63, Buea, Cameroon.
S Ariane ChristieProgram for the Advancement of Surgical Equity, Department of Surgery, University of California Los Angeles, 10833 Le Conte Ave, Suite 7V-111 CHS, Los Angeles, CA 90095, United States of America.

Funding

University of California Launching Future Leaders in Global Health Research Training ProgramD43TW009343 · FIC · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CRAIG R COHEN, Sung-Jae Lee · 2017 to 2026
$14.7M
The Data Science Center for the Study of Surgery and Injury in Africa (D-SINE-Africa)U54TW012087 · FIC · UNIVERSITY OF BUEA · PI Alain Mefire Chichom, Alan E Hubbard · 2021 to 2026
$7.3M
FIC NIH HHS D43 TW009343FIC NIH HHS U54 TW012087
6 · The paper itself

Abstract

backgroundGlobal surgery research efforts have been criticized for failure to transition from problem identification to intervention implementation. We developed a context-appropriate trauma quality improvement (TQI) bundle to ameliorate care gaps at a regional referral hospital in Cameroon. We determined associations between bundle implementation and improvement in trauma resuscitation practices.

methodsWe implemented a TQI bundle consisting of a hospital-specific trauma protocol, staff training, a trauma checklist, provision of essential emergency trauma supplies in the resuscitation area, and monthly quality improvement meetings. We compared trends in target process measures (e.g., frequency and timing of vital sign collection and primary survey interventions) in the six-month period pre- and post-bundle implementation using Wilcoxon rank-sum and Fisher's exact tests.

resultsWe compared 246 pre-bundle patients with 203 post-bundle patients. Post-bundle patients experienced a greater proportion of all vital signs collected compared to the pre-intervention cohort (0 % pre-bundle vs. 69 % post-bundle, p < 0.001); specifically, the proportion of respiratory rate (0.8 % pre-bundle vs. 76 % post-bundle, p < 0.001) and temperature (7 % pre-bundle vs. 91 % post-bundle, p < 0.001) vital sign collection significantly increased. The post-bundle cohort had vital signs measured sooner (74 % vital signs measured within 15 min of arrival pre-bundle vs. 90 % post-bundle, p < 0.001) and more frequently per patient (7 % repeated vitals pre-bundle vs 52 % post-bundle, p < 0.001). Key primary survey interventions such as respiratory interventions (1 % pre-bundle vs. 8 % post-bundle, p < 0.001) and cervical collar placement (0 % pre-bundle vs. 7 % post-bundle, p < 0.001) also increased in the post-bundle cohort.

conclusionsThe implementation of a context-appropriate TQI bundle was associated with significant improvements in previously identified trauma care deficits at a single regional hospital. Data-derived interventions targeting frontline capacity at the local level can bridge the gap between identifying care limitations and improvement in resource-limited settings.

Indexed as

Quality ImprovementWounds and InjuriesAdultCameroonChecklistFemaleHumansMalePatient Care BundlesResuscitationTrauma CentersEmergency medicineGlobal surgeryInjuryQuality improvementSub-Saharan AfricaTrauma surgery

Identifiers

PMID38772755
PMCPMC12009632

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.