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  • Roy, Nobhojit  (8)
  • Gruen, Russell L.
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  • 1
    Language: English
    In: World Journal of Surgery, 2016, Vol.40(11), pp.2611-2619
    Description: To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00268-016-3614-y Byline: Kathleen M. O'Neill (1,2), Sarah L. M. Greenberg (1,3), Meena Cherian (4), Rowan D. Gillies (5), Kimberly M. Daniels (1,6), Nobhojit Roy (7,8), Nakul P. Raykar (1,9), Johanna N. Riesel (1,10), David Spiegel (11), David A. Watters (12,13), Russell L. Gruen (14,15) Abstract: Background Surgical conditions represent a significant proportion of the global burden of disease, and therefore, surgery is an essential component of health systems. Achieving universal health coverage requires effective monitoring of access to surgery. However, there is no widely accepted standard for the required capabilities of a first-level hospital. We aimed to determine whether a group of operations could be used to describe the delivery of essential surgical care. Methods We convened an expert panel to identify procedures that might indicate the presence of resources needed to treat an appropriate range of surgical conditions at first-level hospitals. Using data from the World Health Organization Emergency and Essential Surgical Care Global database, collected using the WHO Situational Analysis Tool (SAT), we analysed whether the ability to perform each of these procedures--which we term "bellwether procedures"--was associated with performing a full range of essential surgical procedures. Findings The ability to perform caesarean delivery, laparotomy, and treatment of open fracture was closely associated with performing all obstetric, general, basic, emergency, and orthopaedic procedures (p 〈 0.001) in the population that responded to the WHO SAT Survey. Procedures including cleft lip, cataract, and neonatal surgery did not correlate with performing the bellwether procedures. Interpretation Caesarean delivery, laparotomy, and treatment of open fractures should be standard procedures performed at first-level hospitals. With further validation in other populations, local managers and health ministries may find this useful as a benchmark for what first-level hospitals can and should be able to perform on a 24/7 basis in order to ensure delivery of emergency and essential surgical care to their population. Those procedures which did not correlate with the bellwether procedures can be referred to a specialized centre or collected for treatment by a visiting specialist team. Author Affiliation: (1) Program in Global Surgery and Social Change, Harvard Medical School, 641 Huntington Ave, Boston, MA, 02115, USA (2) Department of Surgery, Yale New Haven Hospital, 1245 Chapel Street Apt 503, New Haven, CT, 06510, USA (3) Department of Surgery, Medical College of Wisconsin, 8701 W Watertown Plank Rd, Milwaukee, WI, 53226, USA (4) WHO Emergency and Essential Surgical Care Programme, The World Health Organization, Headquarters, Geneva, Switzerland (5) Royal North Shore Hospital, Plastic, Reconstructive and Burns, Reserve Rd, St Leonards, NSW, 2065, Australia (6) Department of Plastic and Oral Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA (7) Department of Surgery, Bhabha Atomic Research Center (BARC) Hospital, Mumbai, 94, India (8) Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden (9) Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA, 02215, USA (10) The Harvard Program in Plastic Surgery, Boston, MA, 02114, USA (11) Department of Orthopedics, Children's Hospital of Philadelphia, Philadelphia, PA, USA (12) Royal Australasian College of Surgeons, East Melbourne, VIC, Australia (13) School of Medicine, Faculty of Health, Barwon Health, Deakin University, Geelong, VIC, Australia (14) The Alfred Hospital and Monash University, Melbourne, VIC, 3051, Australia (15) Nanyang Technological University, 50 Nanyang Drive, Research Techno Plaza, Level 4 X-Frontiers Block, Singapore, 637553, Singapore Article History: Registration Date: 11/06/2016 Online Date: 28/06/2016 Article note: Disclaimer: The authors include WHO staff. The views expressed in this publication reflect their views and not necessarily that of WHO.
    Keywords: Delivery (Childbirth) -- Analysis ; Laparotomy -- Analysis;
    ISSN: 0364-2313
    E-ISSN: 1432-2323
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  • 2
    Language: English
    In: American Journal of Obstetrics and Gynecology, September 2015, Vol.213(3), pp.338-340
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ajog.2015.04.010 Byline: John G. Meara, Andrew J.M. Leather, Lars Hagander, Blake C. Alkire, Nivaldo Alonso, Emmanuel A. Ameh, Stephen W. Bickler, Lesong Conteh, Anna J. Dare, Justine Davies, Eunice Derivois Merisier, Shenaaz El-Halabi, Paul E. Farmer, Atul Gawande, Rowan Gillies, Sarah L.M. Greenberg, Caris E. Grimes, Russell L. Gruen, Edna Adan Ismail, Thaim Buya Kamara, Chris Lavy, Ganbold Lundeg, Nyengo C. Mkandawire, Nakul P. Raykar, Johanna N. Riesel, Edgar Rodas, John Rose, Nobhojit Roy, Mark G. Shrime, Richard Sullivan, Stephane Verguet, David Watters, Thomas G. Weiser, Iain H. Wilson, Gavin Yamey, Winnie Yip Author Affiliation: (a) Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA (b) Department of Otology and Laryngology, Harvard Medical School, Boston Children's Hospital, Boston, MA (c) Harvard Medical School, Boston Children's Hospital, Boston, MA (d) Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA (e) Office of Global Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA (f) Department of Global Health and Social Medicine, Division of Global Health Equity, Harvard Medical School and Brigham and Women's Hospital, Boston, MA (g) Partners in Health, Boston, MA (h) Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA (i) Ariadne Labs, Boston, MA (j) Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA (k) Department of Surgery, Massachusetts General Hospital, Boston, MA (l) Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA (m) King's Centre for Global Health, King's Health Partners and King's College London, London, United Kingdom (n) School of Public Health, Imperial College London, London, United Kingdom (o) The Lancet, London, United Kingdom (p) Institute of Cancer Policy, Kings Health Partners Integrated Cancer Centre, King's Centre for Global Health, King's College London, London, United Kingdom (q) Pediatric Surgery and Global Pediatrics, Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden (r) Department of Plastic Surgery, University of Sao Paulo, Sao Paulo, Brazil (s) Department of Surgery, Division of Peadiatric Surgery, National Hospital, Abuja, Nigeria (t) Rady Children's Hospital, University of California, San Diego, San Diego, CA (u) Department of Surgery, University of California, San Diego, San Diego, CA (v) Department of the Ministry of Health, Gressier, Ouest, Haiti (w) Ministry of Health, Gaborone, Republic of Botswana (x) Royal North Shore Hospital, St Leonards, New South Wales, Australia (y) Medical College of Wisconsin, Milwaukee, WI (z) The Alfred Hospital and Monash University, Melbourne, Victoria, Australia and Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (aa) Royal Australasian College of Surgeons, East Melbourne, and Deakin University, Melbourne, Victoria, Australia (bb) Edna Adan University Hospital, Hargeisa, Somaliland (cc) Connaught Hospital, Freetown, Sierra Leone (dd) Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom (ee) Blavatnik School of Government, University of Oxford, Oxford, United Kingdom (ff) Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia (gg) Department of Surgery, College of Medicine, University of Malawi, Blantyre, Malawi (hh) School of Medicine, Flinders University, Adelaide, South Australia, Australia (ii) The Cinterandes Foundation, Universidad del Cuenca, and Universidad del Azuay, Cuenca, Ecuador (jj) Universidad del Azuay, Cuenca, Ecuador (kk) BARC Hospital, Mumbai, India (ll) Harvard Interfaculty Initiative in Health Policy, Cambridge, MA (mm) Department of Surgery, Stanford University School of Medicine, Stanford, CA (nn) Department of Anaesthesia, Royal Devon and Exeter National Health Service Foundation Trust, Exeter, United Kingdom (oo) Evidence to Policy Initiative, Global Health Group, University of California, San Francisco, San Francisco, CA Article Note: (footnote) This article was originally published in its entirety in The Lancet., Drs Meara and Hagander and Mr Leather contributed equally to this work.
    Keywords: Medicine
    ISSN: 0002-9378
    E-ISSN: 1097-6868
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  • 3
    Language: English
    In: The Lancet, 08 August 2015, Vol.386(9993), pp.569-624
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/S0140-6736(15)60160-X Byline: John G Meara, Andrew J M Leather, Lars Hagander, Blake C Alkire, Nivaldo Alonso, Emmanuel A Ameh, Stephen W Bickler, Lesong Conteh, Anna J Dare, Justine Davies, Eunice Derivois Merisier, Shenaaz El-Halabi, Paul E Farmer, Atul Gawande, Rowan Gillies, Sarah L M Greenberg, Caris E Grimes, Russell L Gruen, Edna Adan Ismail, Thaim Buya Kamara, Chris Lavy, Ganbold Lundeg, Nyengo C Mkandawire, Nakul P Raykar, Johanna N Riesel, Edgar Rodas, John Rose, Nobhojit Roy, Mark G Shrime, Richard Sullivan, Stephane Verguet, David Watters, Thomas G Weiser, Iain H Wilson, Gavin Yamey, Winnie Yip Author Affiliation: (a) Program in Global Surgery and Social Change, Department of Global Health and Social Medicine, Harvard Medical School, Boston, USA (b) Department of Otology and Laryngology, Harvard Medical School, Boston, USA (c) Boston Children's Hospital, Boston, MA, USA (d) King's Centre for Global Health, King's Health Partners and King's College London, London, UK (e) Pediatric Surgery and Global Pediatrics, Department of Pediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden (f) Department of Otolaryngology -- Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA (g) Office of Global Surgery, Massachusetts Eye and Ear Infirmary, Boston, MA, USA (h) Plastic Surgery Department, University of Sao Paulo, Sao Paulo, Brazil (i) Department of Surgery, Division of Peadiatric Surgery, National Hospital, Abuja, Nigeria (j) Rady Children's Hospital, University of California, San Diego, San Diego, CA, USA (k) Department of Surgery, University of California, San Diego, CA, USA (l) School of Public Health, Imperial College London, London, UK (m) The Lancet, London, UK (n) Department of Ministry of Health, Gressier, Ouest, Haiti (o) Ministry of Health, Republic of Botswana, Boston, MA, USA (p) Department of Global Health and Social Medicine, Division of Global Health Equity, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA (q) Partners in Health, Boston, MA, USA (r) Center for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA (s) Ariadne Labs Boston, MA, USA (t) Royal North Shore Hospital, St Leonards, NSW, Australia (u) Medical College of Wisconsin, Milwaukee, WI, USA (v) The Alfred Hospital and Monash University, Melbourne, VIC, Australia (w) Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore (x) Edna Adan University Hospital, Hargeisa, Somaliland (y) Connaught Hospital, Freetown, Sierra Leone (z) Department of Surgery, University of Sierra Leone, Freetown, Sierra Leone (aa) Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK (ab) Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia (ac) Department of Surgery, College of Medicine, University of Malawi, Blantyre, Malawi (ad) School of Medicine, Flinders University, Adelaide, SA, Australia (ae) Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA (af) Department of Surgery, Massachusetts General Hospital, Boston, MA, USA (ag) The Cinterandes Foundation, Universidad del Cuenca, and Universidad del Azuay, Cuenca, Ecuador (ah) Universidad del Azuay, Cuenca, Ecuador (ai) BARC Hospital (Govt of India), Mumbai, India (aj) Harvard Interfaculty Initiative in Health Policy, Cambridge, MA, USA (ak) Institute of Cancer Policy, Kings Health Partners Integrated Cancer Centre, King's Centre for Global Health, King's College London, London, UK (al) Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA (am) Royal Australasian College of Surgeons, East Melbourne, and Deakin University, Melbourne, VIC, Australia (an) Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA (ao) Department of Anaesthesia, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK (ap) Evidence to Policy Initiative, Global Health Group, University of California, San Francisco, CA, USA (aq) Blavatnik School of Government, University of Oxford, Oxford, UK
    Keywords: Medicine
    ISSN: 0140-6736
    E-ISSN: 1474-547X
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  • 4
    Language: English
    In: World Journal of Surgery, April, 2017, Vol.41(4), p.954(9)
    Description: To access, purchase, authenticate, or subscribe to the full-text of this article, please visit this link: http://dx.doi.org/10.1007/s00268-016-3759-8 Byline: Angela Lashoher (1), Eric B. Schneider (2,3), Catherine Juillard (4), Kent Stevens (5), Elizabeth Colantuoni (6), William R. Berry (7), Christina Bloem (8), Witaya Chadbunchachai (9), Satish Dharap (10), Sydney M. Dy (11), Gerald Dziekan (12), Russell L. Gruen (13), Jaymie A. Henry (14), Christina Huwer (15), Manjul Joshipura (16), Edward Kelley (17), Etienne Krug (18), Vineet Kumar (19), Patrick Kyamanywa (20), Alain Chichom Mefire (21), Marcos Musafir (22), Avery B. Nathens (23), Edouard Ngendahayo (24), Thai Son Nguyen (25), Nobhojit Roy (26), Peter J. Pronovost (27), Irum Qumar Khan (28), Junaid Abdul Razzak (29,30), Andres M. Rubiano (31), James A. Turner (32), Mathew Varghese (33), Rimma Zakirova (34), Charles Mock (35) Abstract: Background Trauma contributes more than ten percent of the global burden of disease. Initial assessment and resuscitation of trauma patients often requires rapid diagnosis and management of multiple concurrent complex conditions, and errors are common. We investigated whether implementing a trauma care checklist would improve care for injured patients in low-, middle-, and high-income countries. Methods From 2010 to 2012, the impact of the World Health Organization (WHO) Trauma Care Checklist program was assessed in 11 hospitals using a stepped wedge pre- and post-intervention comparison with randomly assigned intervention start dates. Study sites represented nine countries with diverse economic and geographic contexts. Primary end points were adherence to process of care measures secondary data on morbidity and mortality were also collected. Multilevel logistic regression models examined differences in measures pre- versus post-intervention, accounting for patient age, gender, injury severity, and center-specific variability. Results Data were collected on 1641 patients before and 1781 after program implementation. Patient age (mean 34 [+ or -] 18 vs. 34 [+ or -] 18), sex (21 vs. 22 % female), and the proportion of patients with injury severity scores (ISS) a[yen] 25 (10 vs. 10 %) were similar before and after checklist implementation (p 〉 0.05). Improvement was found for 18 of 19 process measures, including greater odds of having abdominal examination (OR 3.26), chest auscultation (OR 2.68), and distal pulse examination (OR 2.33) (all p 〈 0.05). These changes were robust to several sensitivity analyses. Conclusions Implementation of the WHO Trauma Care Checklist was associated with substantial improvements in patient care process measures among a cohort of patients in diverse settings. Author Affiliation: (1) 14 Chemin de Contamine, 01420, Chanay, France (2) Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, 1620 Tremont Street, Suite 4-020, Boston, MA, 02120, USA (3) Johns Hopkins Surgery Center for Outcomes Research, Johns Hopkins School of Medicine, Baltimore, MD, USA (4) Department of Surgery, Center for Global Surgical Studies, University of California, San Francisco, 1001 Potrero Ave, 3A, San Francisco, CA, 94110, USA (5) The Johns Hopkins School of Medicine, 1800 Orleans Street, Suite 6107E, Baltimore, MD, 21287, USA (6) Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe Street, Baltimore, MD, 21205, USA (7) Department of Health Policy and Management, Harvard School of Public Health, 401 Park Drive, Boston, MA, 02215, USA (8) Department of Emergency Medicine, SUNY Downstate Medical Center, 450 Clarkson Ave, Box 1228, Brooklyn, NY, 11203, USA (9) WHO Collaborating Center for Injury Prevention and Safety Promotion, Khon Kaen Hospital, Khon Kaen, 40000, Thailand (10) Department of Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, 400022, India (11) Johns Hopkins Bloomberg School of Public Health, Rm 609, 624 N Broadway, Baltimore, MD, 21205, USA (12) World Self-Medication Industry, Rue de Cossonay 5, Case Postale 124, 1023, Crissier, Switzerland (13) Lee Kong Chian School of Medicine, Nanyang Technological University, Research Techno Plaza, 02-07, 50 Nanyang Drive, Singapore, 637553, Singapore (14) Department of Surgery, The University of Chicago, 5841 S Maryland Ave, Chicago, IL, 60637, USA (15) Clinic for Trauma Surgery and Orthopedics, Unfallkrankenhaus Berlin, Warener Str. 7, 12683, Berlin, Germany (16) Academy of Traumatology, 504, Sangita Complex, Parimal Garden, Ahmadabad, 380015, India (17) Service Delivery and Safety Department, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland (18) Department for the Management of NCDs, Disability, Violence and Injury Prevention, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland (19) Department of Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, College Building, First Floor, Sion, Mumbai, 400022, India (20) School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Nyarugenge Campus, P.O. Box. 3286, Kigali, Rwanda (21) Faculty of Health Sciences, University of Buea and Regional Hospital Limbe, P.O. Box 25526, Yaounde, Cameroon (22) Federal University of Rio de Janeiro, Rua Voluntarios da Patria, 445 SL 201, Botafogo, Rio de Janeiro, CEP: 22270-005, Brazil (23) Department of Surgery, University of Toronto and Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room D5 74, Toronto, Ontario, M4N 3M5, Canada (24) University Teaching Hospital of Kigali, P.O. Box 2534, Kigali, Rwanda (25) Duc Giang General Hospital, 54 Truong Lam, Long Bien, Hanoi, Vietnam (26) Department of Surgery, BARC hospital (Govt of India), HBNI University, Anushaktinagar, Mumbai, 400094, India (27) Johns Hopkins Medicine, 600 N Wolfe Street, CMSC 131, Baltimore, MD, 21287, USA (28) Department of Emergency Medicine, Aga Khan University, 1st floor, Stadium Road, P.O. Box 3500, Karachi, 74800, Pakistan (29) Johns Hopkins University School of Medicine, 5801 Smith Ave, Ste 220, Baltimore, MD, 21219, USA (30) Aga Khan University, Karachi, Pakistan (31) MEDITECH Foundation, Neiva University Hospital, Calle 5 11-19, Huila, Neiva, Colombia (32) Department of Paedeatric Orthopedics, Sick Kids Hospital, 555 University Ave, Toronto, ON, M5G 1X8, Canada (33) Department of Orthopaedics, St Stephen's Hospital, Tis Hazari, Delhi, 110054, India (34) St. Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada (35) Department of Surgery, Harborview Medical Center, HIPRC, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA, 98104, USA Article History: Registration Date: 04/10/2016 Online Date: 31/10/2016
    Keywords: Public Health -- Economic Aspects
    ISSN: 0364-2313
    E-ISSN: 14322323
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  • 5
    Language: English
    In: International Journal of Obstetric Anesthesia, February 2016, Vol.25, pp.75-78
    Description: To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ijoa.2015.09.006 Byline: John G. Meara, Andrew J.M. Leather, Lars Hagander, Blake C. Alkire, Nivaldo Alonso, Emmanuel A. Ameh, Stephen W. Bickler, Lesong Conteh, Anna J. Dare, Justine Davies, Eunice Derivois Merisier, Shenaaz El-Halabi, Paul E. Farmer, Atul Gawande, Rowan Gillies, Sarah L.M. Greenberg, Caris E. Grimes, Russell L. Gruen, Edna Adan Ismail, Thaim Buya Kamara, Chris Lavy, Ganbold Lundeg, Nyengo C. Mkandawire, Nakul P. Raykar, Johanna N. Riesel, Edgar Rodas, John Rose, Nobhojit Roy, Mark G. Shrime, Richard Sullivan, Stephane Verguet, David Watters, Thomas G. Weiser, Iain H. Wilson, Gavin Yamey, Winnie Yip Article Note: (footnote) ** This article is a reprint of a previously published article. For citation purposes, please use the original publication details; Maturitas, 14(2), pp. 103-115. DOI of original item: http://dx.doi.org/10.1016/S0140-6736(15)60160-X. Reproduced with permission from The Lancet.
    Keywords: Medicine
    ISSN: 0959-289X
    E-ISSN: 1532-3374
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  • 6
    Language: English
    In: Surgery, July 2015, Vol.158(1), pp.3-6
    Keywords: Medicin Och Hälsovetenskap ; Klinisk Medicin ; Kirurgi ; Medical And Health Sciences ; Clinical Medicine ; Surgery;
    ISSN: 0039-6060
    E-ISSN: 1532-7361
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  • 7
    Language: English
    In: World journal of surgery, April 2017, Vol.41(4), pp.954-962
    Description: Trauma contributes more than ten percent of the global burden of disease. Initial assessment and resuscitation of trauma patients often requires rapid diagnosis and management of multiple concurrent complex conditions, and errors are common. We investigated whether implementing a trauma care checklist would improve care for injured patients in low-, middle-, and high-income countries. From 2010 to 2012, the impact of the World Health Organization (WHO) Trauma Care Checklist program was assessed in 11 hospitals using a stepped wedge pre- and post-intervention comparison with randomly assigned intervention start dates. Study sites represented nine countries with diverse economic and geographic contexts. Primary end points were adherence to process of care measures; secondary data on morbidity and mortality were also collected. Multilevel logistic regression models examined differences in measures pre- versus post-intervention, accounting for patient age, gender, injury severity, and center-specific variability. Data were collected on 1641 patients before and 1781 after program implementation. Patient age (mean 34 ± 18 vs. 34 ± 18), sex (21 vs. 22 % female), and the proportion of patients with injury severity scores (ISS) ≥ 25 (10 vs. 10 %) were similar before and after checklist implementation (p 〉 0.05). Improvement was found for 18 of 19 process measures, including greater odds of having abdominal examination (OR 3.26), chest auscultation (OR 2.68), and distal pulse examination (OR 2.33) (all p 〈 0.05). These changes were robust to several sensitivity analyses. Implementation of the WHO Trauma Care Checklist was associated with substantial improvements in patient care process measures among a cohort of patients in diverse settings.
    Keywords: Checklist ; Process Assessment (Health Care) -- Standards ; Wounds and Injuries -- Therapy
    E-ISSN: 1432-2323
    Source: MEDLINE/PubMed (U.S. National Library of Medicine)
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  • 8
    Language: English
    In: World journal of surgery, October 2019, Vol.43(10), pp.2426-2437
    Description: The completeness of a trauma registry's data is essential for its valid use. This study aimed to evaluate the extent of missing data in a new multicentre trauma registry in India and to assess the association between data completeness and potential predictors of missing data, particularly mortality. The proportion of missing data for variables among all adults was determined from data collected from 19 April 2016 to 30 April 2017. In-hospital physiological data were defined as missing if any of initial systolic blood pressure, heart rate, respiratory rate, or Glasgow Coma Scale were missing. Univariable... Data on the 4466 trauma patients in the registry were analysed. Out of 59 variables, most (n = 51; 86.4%) were missing less than 20% of observations. There were 808 (18.1%) patients missing at least one of the first in-hospital physiological observations. Hospital death was associated with missing in-hospital... Most variables were well collected. Hospital death, a proxy for more severe injury, was associated with missing first in-hospital physiological observations. This remains an important limitation for trauma registries.
    Keywords: Heart Rate -- Analysis;
    ISSN: 03642313
    E-ISSN: 1432-2323
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