[Organizational, personnel and structural alterations due to participation in TraumaNetworkD DGU. The first stocktaking].
BACKGROUND
By implementation of a nationwide trauma network in Germany a high quality standard of technical, personnel and scientific conditions should be attained in hospitals participating in care for severely injured patients. All hospitals audited within the framework of TraumaNetwork(D) DGU are also evaluated for the modifications undertaken by answering a questionnaire. Using this data  it was possible to 1) obtain information about hitherto existing personnel and technical infrastructures of all participating hospitals and 2) to present first positive effects achieved by implementation and participating in TraumaNetwork(D) DGU.


METHODS
The questionnaire contained 41 questions concerning organizational, personnel and structural changes to justify the motivation for participating in TraumaNetwork(D) DGU and regarding the degree of confidence with reference to the work of the AKUT office. Analysis of data has been carried out and given as a percentage of all useable questionnaires.


RESULTS
Data of 138 hospitals has been evaluated. Regarding organizational changes 29% of national/supraregional trauma centers made fewer adjustments than local (44%) and regional (55%) trauma centers. Personnel changes mainly affected participation in ATLS courses, cooperation with a neurosurgical department and reorganization of work schedules.                         With respect to structural changes most frequently emergency operating sets for emergency surgery have been established, teleradiology systems have been implemented and in 25% of the cases a sonography unit has been acquired. The rarest, but also most cost-intensive, new acquisition has been a CT scanner in or close to the emergency trauma room (10%). The work of the AKUT office has been rated altogether more satisfying by local trauma centers (mean 2.4) than by regional and national trauma centers (mean 2.6). Prompt information by AKUT has been especially praised (mean 2.1).


CONCLUSIONS
Being organized in trauma networks motivates hospitals to optimize their operational sequences and personnel and structural conditions. How much the care for multiple injured patients can be improved nationwide in Germany will be shown over the next few years. Through compulsive participation in TraumaRegister(QM) DGU (quality management) as a measurement for quality assurance this will be analyzed and evaluated scientifically.
Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, 35043, Marburg, Deutschland.
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Mand
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Müller
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Ruchholtz
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Künzel
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Kühne
D019058:Community Networks / Q000458:organization & administration* / Q000706:statistics & numerical data*; D005858:Germany / Q000453:epidemiology; D006801:Humans; D009104:Multiple Trauma / Q000453:epidemiology* / Q000628:therapy*; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D015995:Prevalence; D011795:Surveys and Questionnaires; D014193:Trauma Centers / Q000458:organization & administration* / Q000706:statistics & numerical data*