title: Establishing components of high-quality injury care: Focus groups with patients and patient families.
abstract: BACKGROUND
  Each year, injuries affect 700 million people worldwide, more than 5 million people die of injuries, and 68,000 survivors remain permanently impaired. Half of all critically injured patients do not receive recommended care, and medical errors are common. Little is known about the aspects of injury care that are important to patients and their families. The purpose of this study was to explore the views of patients and families affected by injury on desired components of injury care in the hospital setting.
  
  
  METHODS
  With the use of a grounded theory approach, this qualitative study involved focus groups with injured patients, family members of survivors, and bereaved family members from four Canadian trauma (injury care) centers.
  
  
  RESULTS
  Thirty-eight participants included injured patients (n = 16), family members of survivors (n = 13), and bereaved family members (n = 9) across four trauma (injury care) centers in different jurisdictions. Participants articulated numerous themes reflecting important components of injury care organized across three domains as follows: clinical care (staff availability, professionalism, physical comfort, adverse events), holistic care (patient wellness, respect for patient and family, family access to patient, family wellness, hospital facilities, supportive care), and communication and information (among staff, with or from staff, content, delivery, and timing). Bereaved family members commented on decision making and end-of-life processes. Subthemes were revealed in most of these themes. Trends by site or type of participant were not identified.
  
  
  CONCLUSIONS
  The framework of patient- and family-derived components of quality injury care could be used by health care managers and policy makers to guide quality improvement efforts. Further research is needed to extend and validate these components among injured patients and families elsewhere. Translating these components into quality indicators and blending those with measures that reflect a provider perspective may offer a comprehensive means of assessing injury care.
authors.affiliation: From the University Health Network (A.R.G.); and Sunnybrook Health Sciences Centre (A.N.), Toronto, Ontario; Department of Community Health Sciences (J.M.B., H.T.S.), and Institute for Public Health (H.T.S.), University of Calgary; and Departments of Medicine (H.T.S.), and Critical Care Medicine (H.T.S.), University of Calgary and Alberta Health Services, Calgary Zone, Calgary, Alberta; Vancouver General Hospital (D.E.), Vancouver; and Interior Health Authority (L.G.), Kelowna, British Columbia, Canada.
authors.forename: Anna R
authors.initials: AR
authors.lastname: Gagliardi
authors.forename: Jamie M
authors.initials: JM
authors.lastname: Boyd
authors.forename: David
authors.initials: D
authors.lastname: Evans
authors.forename: Lynn
authors.initials: L
authors.lastname: Gerein
authors.forename: Avery
authors.initials: A
authors.lastname: Nathens
authors.forename: Henry Thomas
authors.initials: HT
authors.lastname: Stelfox