title: A qualitative study to identify opportunities for improving trauma quality improvement.
abstract: BACKGROUND
  Quality improvement (QI) is a central tenant of trauma center accreditation in most countries, but its effectiveness is largely unknown. We sought to explore opportunities for improving trauma QI.
  
  
  METHODS
  We performed a qualitative research study using grounded theory analyses of interviews with medical directors and program managers from 75 verified trauma centers sampled from the United States (n = 51), Canada (n = 14), and Australasia (Australia and New Zealand [n = 10]) to explore experiences with trauma QI activities and identify opportunities for improvement.
  
  
  RESULTS
  Most trauma centers indicated that they perceived trauma QI to be important and devoted personnel for QI (data entry, data analyst, educator, nurse practitioner). Programs identified 5 principal opportunities to improve trauma QI: (1) ensure resource adequacy (human resources, registry maintenance, financial support, institutional support), (2) encourage stakeholder participation (engagement, communication, coordination), (3) ensure clinical relevance, (4) incorporate evidence-based tools, and (5) require provider and QI program accountability.
  
  
  CONCLUSIONS
  Quality improvement programs exist as accreditation requirements in most centers. However, trauma QI practices depend on a range of local and regional factors, and concrete opportunities for improvement that address impact and sustainability exist.
authors.affiliation: Department of Community Health Sciences, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada. mjsantan@ucalgary.ca
authors.forename: Maria Jose
authors.initials: MJ
authors.lastname: Santana
authors.forename: Sharon
authors.initials: S
authors.lastname: Straus
authors.forename: Russell
authors.initials: R
authors.lastname: Gruen
authors.forename: Henry T
authors.initials: HT
authors.lastname: Stelfox
mesh_terms: D000068:Accreditation; D006739:Hospital Administration / Q000592:standards*; D006801:Humans; D007407:Interviews as Topic; D036301:Qualitative Research; D058996:Quality Improvement / Q000458:organization & administration*; D019984:Quality Indicators, Health Care; D014193:Trauma Centers / Q000458:organization & administration* / Q000592:standards; D014947:Wounds and Injuries / Q000628:therapy*