Perceived impact of trauma audit filters on trauma care in a tertiary care hospital: a qualitative analysis

Perceived impact of trauma audit filters on trauma care in a tertiary care hospital: a qualitative analysis

Jyothis Greeshma Abraham , Anurag Mishra
Maulana Azad Medical College, New Delhi, India

Trauma, external injury in combination with the body’s response, is a major threat to global population. Trauma care is time sensitive, early identification of fatal injuries and conditions are very essential for survival and care of the person. Quality of trauma care remains a big concern in LMICs. Trauma has also been recognised by SDG 3 and targets to reduce trauma burden.

We at Maulana Azad Medical College (MAMC), New Delhi conducted a survey in a hybrid setup (in-person, phone call) with Trauma Audit Board (TAB) members associated with another ongoing Project on Trauma Filters at MAMC.

AIM: To know, the creation of TAB has been useful or burden in patient, hospital management or with Physicians etc.

Composition of TAB- Medical Director of the hospital, Heads of Emergency, Anaesthesia, Radiology, Orthopaedics, Surgery etc., and Investigators associated with the project.

Method of Survey:
A semi-quantitative questionnaire to record their feedback and impression via means using hybrid setup as per the clinician’s convenience, about TAB and their opinion about such audit board meetings, it’s impact on Trauma Care and other hospital-based problems.

Link to questionnaire:
https://docs.google.com/forms/d/e/1FAIpQLSdx8qT6LKZVYTbogCbBcRGRN8rK0lpcZ0-126C0Cus-Fw6twg/viewform?usp=sf_link

Results:
Each clinician associated with project was 3.81 years. Only the MD of the hospital changed after his tenure of 2 years. Board was intact since its inception from 2017.

Clinicians noted a mean average of 7.27 on a scale of 1 to 10, after the implementation of TAB meetings.

To exemplify the scale, 2-3 popular responses as follows:
• Monitoring of Vitals like GCS, Respiratory rate, Blood pressure were noted which were earlier missed.
• Ultrasound machines were setup near patient bedside in Casualty.
• Trauma patients were managed in a more systematic way without wastage of time in inter departmental referrals.
• More responsible, more vigilant and aware as data were recorded and cases were studied in audit meetings

Other than trauma care an impact was seen in overall hospital functioning with inter-departmental co-ordination, more productivity in patient management were seen even during Covid waves with easy referrals with just an update on WhatsApp group which were initially created for the board meetings.
Many Clinicians even realised an impact on themselves with change in behavioural, attitudinal and inter-personnel skills, with such meetings they could learn from cases and functioning of other departments which would otherwise be missed. On a scale ranging from 1 to 10 when asked about how much of a burden it was attending TAB meetings on an average only 2.36% of a burden on a monthly basis which is quite negligible, as more clinicians looked upon learning more things for better patient care. Recommendation to other Institutes about such TAB meetings was a definite Yes.

Conclusion:
Findings suggest a significant difference in healthcare management in the hospital.
Results and opinions suggest such meetings should be more periodically conducted and should be recognised as part of Hospital standardization.

Keywords: Trauma, Audits, Trauma Audit Board, Positive and negative impact