title: Comparison of quality control for trauma management between Western and Eastern European trauma center.
abstract: BACKGROUND
  Quality control of trauma care is essential to define the effectiveness of trauma center and trauma system. To identify the troublesome issues of the system is the first step for validation of the focused customized solutions. This is a comparative study of two level I trauma centers in Italy and Romania and it has been designed to give an overview of the entire trauma care program adopted in these two countries. This study was aimed to use the results as the basis for recommending and planning changes in the two trauma systems for a better trauma care.
  
  
  METHODS
  We retrospectively reviewed a total of 182 major trauma patients treated in the two hospitals included in the study, between January and June 2002. Every case was analyzed according to the recommended minimal audit filters for trauma quality assurance by The American College of Surgeons Committee on Trauma (ACSCOT).
  
  
  RESULTS
  Satisfactory yields have been reached in both centers for the management of head and abdominal trauma, airway management, Emergency Department length of stay and early diagnosis and treatment. The main significant differences between the two centers were in the patients' transfers, the leadership of trauma team and the patients' outcome. The main concerns have been in the surgical treatment of fractures, the outcome and the lacking of documentation.
  
  
  CONCLUSIONS
  The analyzed hospitals are classified as Level I trauma center and are within the group of the highest quality level centers in their own countries. Nevertheless, both of them experience major lacks and for few audit filters do not reach the mmum standard requirements of ACS Audit Filters. The differences between the western and the eastern European center were slight. The parameters not reaching the minimum requirements are probably occurring even more often in suburban settings.
authors.affiliation: Emergency and Trauma Surgery Unite, Maggiore Hospital Trauma Center, Bologna, Italy. gregorio.tugnoli@ausl.bologna.it.
authors.forename: Stefano Massimiliano
authors.initials: SM
authors.lastname: Calderale
authors.forename: Raluca
authors.initials: R
authors.lastname: Sandru
authors.forename: Gregorio
authors.initials: G
authors.lastname: Tugnoli
authors.forename: Salomone
authors.initials: S
authors.lastname: Di Saverio
authors.forename: Mircea
authors.initials: M
authors.lastname: Beuran
authors.forename: Sergio
authors.initials: S
authors.lastname: Ribaldi
authors.forename: Massimo
authors.initials: M
authors.lastname: Coletti
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gambale
authors.forename: Sorin
authors.initials: S
authors.lastname: Paun
authors.forename: Livio
authors.initials: L
authors.lastname: Russo
authors.forename: Franco
authors.initials: F
authors.lastname: Baldoni