An analysis of hospital trauma care performance evaluation.
The purpose of this article was to report on a study on the hospital trauma care performance evaluation based on a database of trauma events of participating UK and European hospitals. Performance evaluation has become increasingly important in the quality assessment of health care in general and trauma care in particular. For many years, attempts to quantifying the performance of trauma care systems on a numerical scale have been developed and applied, including the use of Ws statistic. The Trauma Audit and Research Network collected and managed the data. We first investigated the currently used approaches in the evaluation of trauma care systems, and then proposed an alternative using a statistical control based approach for the comparison of different hospitals at one time. Different control charts and types of calculations were also proposed for the chronologic outcome chart, which plots the variation of trauma care within one hospital over time. New graphical methods for hospital trauma care performance evaluation based on statistical process plots were developed and tested on the project database. A control chart approach to the presentation of the outcome charts for hospital trauma care performance evaluation is presented in this article. The charts are more meaningful than the "caterpillar" plot traditionally used, and avoid the ranking of institutions into "league tables".