title: Assessment of trauma quality improvement activities at public hospitals in Thailand.
abstract: BACKGROUND
  Given the current exceptional burden of injury in Thailand, the proven efficacy of quality improvement programs, and the current scarcity of national-level information on trauma quality improvement program (TQIP) implementation in Thailand, we aimed to examine the use of TQIPs and barriers to TQIP adoption in Thai public trauma centers.
  
  
  METHODS
  We distributed a survey to 110 public hospitals which are designated to provide trauma care in Thailand. The survey assessed the presence or absence of the four core elements of the World Health Organization (WHO) recommended TQIPs (morbidity and mortality (M&M) conferences, preventable death panels, trauma registries, and audit filters), and provider perception of barriers and priorities in TQIP implementation.
  
  
  RESULTS
  Responses were received from 80 (72%) respondents. Seventy-two (90%) reported having a trauma registry and seventy (88%) respondents reported use of audit filters. Seventy (88%) respondents reported conducting regular M&M conferences, and 45 (56%) respondents reported the presence of preventable death panels. Thirty-eight (48%) respondents reported presence of all four elements of WHO TQIPs. The most commonly reported barriers to implementing TQIPs were lack of interest (55; 68%) and lack of time (39; 48%)to implement TQIPs. Audit filters were reported by only 25 (31%) of respondents and optimization of audit filters was the most frequently identified next-step in further development of TQIP.
  
  
  CONCLUSIONS
  Just under half of responding Thai public trauma centers reported implementation of all four elements of the WHO recommended TQIPs. Priority strategies to facilitate TQIP maturation in Thailand should address staff motivation, provision of staff time for TQIP development, and optimization of audit filter use to monitor quality of care.
authors: Anesthesiology and Pain Medicine, and Harborview Injury Prevention and Research Center, University of Washington, USA.
authors: Phuphit
authors: P
authors: Fuangworawong
authors: University of Washington, USA.
authors: Lacey N
authors: LN
authors: LaGrone
authors: World Health Organization Collaborating Center on Injury Prevention and Safety Promotion, Trauma and Critical Care Center, Khon Kaen Regional Hospital, Thailand.
authors: Witaya
authors: W
authors: Chadbunchachai
authors: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkla, Thailand.
authors: Vorasith
authors: V
authors: Sornsrivichai
authors: Surgery, Global Health, and Epidemiology, University of Washington, USA.
authors: Charles N
authors: CN
authors: Mock
authors: Anesthesiology and Pediatrics, Harborview Injury Prevention and Research Center, University of Washington, USA. Electronic address: vavilala@u.washington.edu.
authors: Monica S
authors: MS
authors: Vavilala
mesh_terms: D006297:Health Services Accessibility; D006779:Hospitals, Public; D006801:Humans; D058996:Quality Improvement; D011795:Surveys and Questionnaires; D013785:Thailand; D014193:Trauma Centers
keywords: Quality improvement; Thailand; Trauma