Indicators for the evaluation of musculoskeletal trauma systems: A scoping review and Delphi study.
<h4>Background</h4>Trauma is a leading cause of mortality and morbidity, disproportionately affecting low- and middle-income countries. Musculoskeletal trauma results in the majority of post-traumatic morbidity and disability globally. The literature has reported many performance indicat...
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0290816&type=printable |
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| author | M Dworkin K J Agarwal-Harding M Joseph G Cahill D Konadu-Yeboah E Makasa C Mock MSK Indicator Group |
| author_facet | M Dworkin K J Agarwal-Harding M Joseph G Cahill D Konadu-Yeboah E Makasa C Mock MSK Indicator Group |
| author_sort | M Dworkin |
| collection | DOAJ |
| description | <h4>Background</h4>Trauma is a leading cause of mortality and morbidity, disproportionately affecting low- and middle-income countries. Musculoskeletal trauma results in the majority of post-traumatic morbidity and disability globally. The literature has reported many performance indicators relating to trauma care, but few specific to musculoskeletal injuries.<h4>Study objectives</h4>The purpose of this study was to establish a practical list of performance indicators to evaluate and monitor the quality and equity of musculoskeletal trauma care delivery in health systems worldwide.<h4>Methods</h4>A scoping review was performed that identified performance indicators related to musculoskeletal trauma care. Indicators were organized by phase of care (general, prevention, pre-hospital, hospital, post-hospital) within a modified Donabedian model (structure, process, outcome, equity). A panel of 21 experts representing 45 countries was assembled to identify priority indicators utilizing a modified Delphi approach.<h4>Results</h4>The scoping review identified 1,206 articles and 114 underwent full text review. We included 95 articles which reported 498 unique performance indicators. Most indicators related to the hospital phase of care (n = 303, 60%) and structural characteristics (n = 221, 44%). Mortality (n = 50 articles) and presence of trauma registries (n = 16 articles) were the most frequently reported indicators. After 3 rounds of surveys our panel reached consensus on a parsimonious list of priority performance indicators. These focused on access to trauma care; processes and key resources for polytrauma triage, patient stabilization, and hemorrhage control; reduction and immobilization of fractures and dislocations; and management of compartment syndrome and open fractures.<h4>Conclusions</h4>The literature has reported many performance indicators relating to trauma care, but few specific to musculoskeletal injuries. To create quality and equitable trauma systems, musculoskeletal care must be incorporated into development plans with continuous monitoring and improvement. The performance indicators identified by our expert panel and organized in a modified Donabedian model can serve as a method for evaluating musculoskeletal trauma care. |
| format | Article |
| id | doaj-art-b3aacea65f7c40b4b8ea80e72d93186d |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-b3aacea65f7c40b4b8ea80e72d93186d2025-02-05T05:32:38ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01188e029081610.1371/journal.pone.0290816Indicators for the evaluation of musculoskeletal trauma systems: A scoping review and Delphi study.M DworkinK J Agarwal-HardingM JosephG CahillD Konadu-YeboahE MakasaC MockMSK Indicator Group<h4>Background</h4>Trauma is a leading cause of mortality and morbidity, disproportionately affecting low- and middle-income countries. Musculoskeletal trauma results in the majority of post-traumatic morbidity and disability globally. The literature has reported many performance indicators relating to trauma care, but few specific to musculoskeletal injuries.<h4>Study objectives</h4>The purpose of this study was to establish a practical list of performance indicators to evaluate and monitor the quality and equity of musculoskeletal trauma care delivery in health systems worldwide.<h4>Methods</h4>A scoping review was performed that identified performance indicators related to musculoskeletal trauma care. Indicators were organized by phase of care (general, prevention, pre-hospital, hospital, post-hospital) within a modified Donabedian model (structure, process, outcome, equity). A panel of 21 experts representing 45 countries was assembled to identify priority indicators utilizing a modified Delphi approach.<h4>Results</h4>The scoping review identified 1,206 articles and 114 underwent full text review. We included 95 articles which reported 498 unique performance indicators. Most indicators related to the hospital phase of care (n = 303, 60%) and structural characteristics (n = 221, 44%). Mortality (n = 50 articles) and presence of trauma registries (n = 16 articles) were the most frequently reported indicators. After 3 rounds of surveys our panel reached consensus on a parsimonious list of priority performance indicators. These focused on access to trauma care; processes and key resources for polytrauma triage, patient stabilization, and hemorrhage control; reduction and immobilization of fractures and dislocations; and management of compartment syndrome and open fractures.<h4>Conclusions</h4>The literature has reported many performance indicators relating to trauma care, but few specific to musculoskeletal injuries. To create quality and equitable trauma systems, musculoskeletal care must be incorporated into development plans with continuous monitoring and improvement. The performance indicators identified by our expert panel and organized in a modified Donabedian model can serve as a method for evaluating musculoskeletal trauma care.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0290816&type=printable |
| spellingShingle | M Dworkin K J Agarwal-Harding M Joseph G Cahill D Konadu-Yeboah E Makasa C Mock MSK Indicator Group Indicators for the evaluation of musculoskeletal trauma systems: A scoping review and Delphi study. PLoS ONE |
| title | Indicators for the evaluation of musculoskeletal trauma systems: A scoping review and Delphi study. |
| title_full | Indicators for the evaluation of musculoskeletal trauma systems: A scoping review and Delphi study. |
| title_fullStr | Indicators for the evaluation of musculoskeletal trauma systems: A scoping review and Delphi study. |
| title_full_unstemmed | Indicators for the evaluation of musculoskeletal trauma systems: A scoping review and Delphi study. |
| title_short | Indicators for the evaluation of musculoskeletal trauma systems: A scoping review and Delphi study. |
| title_sort | indicators for the evaluation of musculoskeletal trauma systems a scoping review and delphi study |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0290816&type=printable |
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