Trial reportEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025
Towards sustaining a trauma quality improvement initiative in Ghana: results of a clinical trial.
Trial report in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors.
Funding
Abstract
objectivesData on the sustainability of trauma quality improvement (QI) initiatives has been limited, especially in low- and middle-income countries (LMICs). We sought to determine how use of a standardized trauma intake form (TIF) with built-in memory prompts varied over time and how this affected achievement of key performance indicators (KPIs) of trauma care in Ghana.
methodsWe conducted a randomized clinical trial at eight non-tertiary hospitals (2020-2021). After TIF initiation, percent TIF use and achievement of 16 KPIs were recorded by trained observers. TIF initiation involved engagement with and training for clinicians at each hospital. The study also utilized ongoing monitoring of TIF use with feedback to hospital staff when TIF use was low at a given hospital.
resultsWe enrolled 2,010 injured patients over 14 months. TIF use increased steadily, from 80% (period 1, first 3.5 months), to 84% (period 2, next 3.5 months), to 89% (period 3, subsequent 3.5 months), to 100% (period 4, final 3.5 months) (p < 0.001). Achievement of 12 of 16 KPIs increased significantly. For example, assessment for intraabdominal bleeding went from 84% complete (period 1), to 87% (period 2), to 91% (period 3), to 100% (period 4) (p < 0.001). Fifteen KPIs were performed in over 90% of patients in period 4.
conclusionsSustainable implementation of trauma QI initiatives is feasible in LMICs. Optimal usage required time, with both TIF use and KPI achievement gradually rising over a year. Ongoing monitoring, with feedback and engagement with hospital staff are key to achieving these sustained increases.
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