Trauma Service Queen Mary Hospital

The Trauma Service was formally established in Queen Mary Hospital (QMH) in August 1997. The objectives of this central service are 1) to coordinate clinical and support departments in the delivery of trauma service; 2) to identify problems and issues of common concern in trauma, and; 3) to review, coordinate and develop guidelines, protocols and quality assurance programmes related to trauma care.

Development of Trauma Service in Queen Mary Hospital

Trauma Service Executive Committee (TSEC)

With representatives from various clinical departments, the TSEC meets quarterly and directs quality improvements in the following ways:

• Oversee and direct the development of trauma service in QMH.
• Implementation of related guidelines and policies.
• Review and address issues relating to structure, process and outcome for quality improvement.

Members and Co-opt Members : Representatives from Clinical Departments

Trauma Registry

It is a systematic collection of data from medical and nursing records of major trauma cases attended and/or admitted to QMH. It consists more than 250 items relating to demographic, assessment, resuscitation, outcome/ complications and follow up. Data collection is done by the Trauma Nurse Coordinator.

Interdepartmental Trauma Audit Meeting- Quarterly

It is a multi-disciplinary case review meeting for quality improvement, experience sharing and staff education.

Chairman: A representative from Clinical Department of A&E, Surgery, Anaesthesiology, Orthopaedics, ICU or Neurosurgery

Participants: Medical and nursing staff from concerned clinical departments in QMH and other hospitals.

Organizing: Representatives from Departments of A&E, Surgery, Diagnostic Radiology and Trauma Nurse Coordinator

Program:

• Statistical report
• Case review and discussion
• recommendation for quality improvement

Scenario Drill

It is a multi-disciplinary drill organized and conducted by the Accident and Emergency Department and ICU.

Trauma Service Audit

With the aim to improve quality, trauma service auditing is a systematic critical analysis of the quality of care through setting agreed standards, measuring performance concurrently or retrospectively, comparing performance with standards, identifying the need for improvement and implementing changes.

Currently, some clinical audit activities are in progress, they include:

• appropriateness of trauma team activation,
• trauma team response time > 15 minutes,
• delayed diagnosis (delay in diagnosis for non-musculoskeletal injuries > 24 hours after arrival),
• delayed operations (delay in major operations: craniotomy, exploratory thoracotomy, laparotomy > 4 hours after admission),
• confidential peer review of problematic cases,
• trauma deaths,
• trauma record documentation,
• staying time in AED > 2 hours.

QMH Trauma Centre involved Study