Designing and Conducting Initial Application of a Performance Assessment Model for in-Hospital Trauma Care

Background: Trauma is a major cause of death worldwide, especially in developing countries. The increasing cost of health care and the differences in the quality of provided services indicates the need to assess trauma care. This study aimed to develop and use a performance assessment model for in-hospital trauma care with a focus on traffic injures.Methods: This multi-method study was conducted in three main phases of indicators determination, model development, and model application. Trauma care performance indicators were extracted through literature review and were confirmed using a two-round Delphi survey and experts’ perspective. Two focus group discussions and 16 semi-structured interviews were held to design the initial model. In the next step, components and final form of the model were confirmed following pre-determined factors including importance and necessity, simplicity, clarity, and relevance. Finally, the model was tested by applying it in a trauma center. Results: A total of 50 trauma care indicators were approved after reviewing the literature and obtaining the experts' views. The final model consisted of six components of assessment level, teams, methods, scheduling, frequency, and data source. The model application revealed problems of a selected trauma center in terms of information recording, patient deposition, some clinical services, waiting time for depositing, recording of medical errors and complications, patient follow-up, and patient satisfaction.Conclusion: Performance assessment with an appropriate model can identify deficiencies and failures of provided services in trauma centers. Understanding the current situation is one of the main requirements for designing any quality improvement programs.