title: [Study on the improvement of trauma patient care: TRAUMACAT project].
abstract: Multiple injuries are a major source of morbidity and mortality in young people. The aim of this study was to evaluate the effect of a collaborative strategy to improve the implementation of six clinical indicators, recognized internationally, for the treatment of trauma patient. Prospective, multicentre, pre-and post-intervention study, in ten referral hospitals, offering polytrauma care in Catalonia. 378 patients were recruited for the pre-intervention study and 501 for the post-intervention study. All patients had a history of high-energy trauma requiring admission to critical or semi-critical care unit.
  
  
  METHODS
  collaborative strategy aimed at participating professionals, involving the creation of a panel of experts, appointment of monitors to encourage improvements at each centre, training, distribution of information, material and meetings, to exchange impressions.
  
  
  METHODS
  frequency and characteristics of trauma and percentage of compliance with clinical indicators. Study of 879 trauma patients. The injury mechanism was overall blunt trauma, in both pre and post intervention phases. The medium ISS (injury severity score) was 21 ± 12,8 and the medium TRISS (trauma and injury severity score) was 26,4 ± 11,4. We didn't find differences between both study phases, in relation to the severity of injury. The mortality rate was 11.5%. We observed significant improvement in the performance of chest X-rays (45% vs. 62%) and pelvis X-rays (27% vs. 62%) in the trauma box and in the fixation of the pelvis in patients with a fracture at this site (24% vs. 49%). The use of diagnostic radiology in hemodynamically unstable patients remained low (33%). The collaborative strategy was effective in improving certain indicators of clinical management.
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Parc Taulí, Sabadell, Barcelona, España. Electronic address: snavarro@tauli.cat.
authors.forename: Salvador
authors.initials: S
authors.lastname: Navarro
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: Maylin
authors.initials: M
authors.lastname: Koo
authors.affiliation: Fundació Avedis Donavedian, Barcelona, España.
authors.forename: Carola
authors.initials: C
authors.lastname: Orrego
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Josep Trueta, Girona, España.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Muñoz-Vives
authors.affiliation: Servicio de Cuidados Intensivos, Hospital de la Vall d'Hebron, Barcelona, España.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Rivero
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari Parc Taulí, Sabadell, Barcelona, España.
authors.forename: Sandra
authors.initials: S
authors.lastname: Montmany
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic, Barcelona, España.
authors.forename: Salvi
authors.initials: S
authors.lastname: Prat
authors.affiliation: Servicio de Cuidados Intensivos, Hospital Joan XXIII, Tarragona, España.
authors.forename: Angel
authors.initials: A
authors.lastname: Pobo-Peris
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital Universitari del Mar, Barcelona, España.
authors.forename: Sonia
authors.initials: S
authors.lastname: Puig
authors.affiliation: Servicio de Anestesiología y Reanimación, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España.
authors.forename: Maria Del Mar
authors.initials: Mdel M
authors.lastname: Monerri
authors.affiliation: Servicio de Cirugía General y del Aparato Digestivo, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
authors.forename: Ferran
authors.initials: F
authors.lastname: Caballero
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital de la Vall d'Hebron, Barcelona, España.
authors.forename: Enric
authors.initials: E
authors.lastname: Cáceres
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D000465:Algorithms; D003299:Cooperative Behavior; D003422:Critical Care / Q000592:standards*; D003952:Diagnostic Imaging / Q000706:statistics & numerical data; D003955:Diagnostic Tests, Routine / Q000706:statistics & numerical data; D004496:Education, Continuing; D005260:Female; D019983:Guideline Adherence; D006282:Health Personnel / Q000193:education; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000592:standards; D033183:Interdisciplinary Communication; D007373:Interinstitutional Relations; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D011446:Prospective Studies; D058996:Quality Improvement; D011859:Radiography; D013030:Spain / Q000453:epidemiology; D062606:Tertiary Care Centers / Q000458:organization & administration*; D015599:Trauma Severity Indices; D055815:Young Adult
keywords: Atención inicial; Paciente politraumatizado; Primary survey; Trauma patient