Iowa’s Trauma System Registry Report, 2015

The use of the data include an annual report of the magnitude of injuries in Iowa, the organization of trauma care, the performance of care and outcomes. The Trauma System Advisory Council’s System Evaluation and Quality Improvement Subcommittee routinely review the data for system improvement recommendations. The data has been used for the Burden of Injury Report and injury prevention and control research

Development and pilot of clinical performance indicators for English ambulance services

Introduction: There is a compelling need to develop clinical performance indicators for ambulance services in order to move from indicators based primarily on response times and in light of the changing clinical demands on services. We report on progress on the national pilot of clinical performance indicators for English ambulance services. Method: Clinical performance indicators were developed in five clinical areas: acute myocardial infarction, cardiac arrest, stroke (including transient ischaemic attack), asthma and hypoglycaemia. These were determined on the basis of common acute conditions presenting to ambulance services and in line with a previously published framework. Indicators were piloted by ambulance services in England and results were presented in tables and graphically using funnel (statistical process control) plots. Results: Progress for developing, agreeing and piloting of indicators has been rapid, from initial agreement in May 2007 to completion of the pilot phase by the end of March 2008. The results of benchmarking of indicators are shown. The pilot has informed services in deciding the focus of their improvement programme in 2008 and 2009 and indicators have been adopted for national performance assessment of standards of prehospital care. Conclusion: The pilot will provide the basis for further development of clinical indicators, benchmarking of performance and implementation of specific evidencebased interventions to improve care in areas identified for improvement. A national performance improvement registry will enable evaluation and sharing of effective improvement methods as well as increasing stakeholder and public access to information on the quality of care provided by ambulance services

Development and use of clinical performance indicators for ambulance services and prehospital care: a discussion paper for a clinical quality improvement framework for ambulance services

Clinical Performance Indicators for ambulance services should be developed in line with best evidence, in partnership with clinicians and service users, and linked to national structures for knowledge and evidence, clinical expertise and research and development. Their development should be guided by a performance monitoring protocol. Clinical Performance Indicators for ambulance services should be meaningful, measurable and realistic, aiming to address issues that matter to patients and clinicians, to benchmark performance, to reduce variations within and between health services and to bring about improvements in care for patients and users. Indicators should function as part of a planned clinical quality improvement framework that draws on modern improvement principles, methods, tools and techniques. Clinical Performance Indicators for ambulance services should be designed to provide safe, effective, patient centred, timely, efficient and equitable healthcare. Importantly, they should support clinicians and services in providing better care to their patients. Resources should be made available to trusts to undertake such measurements, to contribute to the national data set, to participate in future development and to deliver the aims of quality improvement

Implementation of a new emergency medical communication centre organization in Finland - an evaluation, with performance indicators

<p>Abstract</p> <p>Background</p> <p>There is a great variety in how emergency medical communication centers (EMCC) are organized in different countries and sometimes, even within countries. Organizational changes in the EMCC have often occurred because of outside world changes, limited resources and the need to control costs, but historically there is often a lack of structured evaluation of these organization changes. The aim of this study was to evaluate if the performance in emergency medical dispatching changed in a smaller community outside Helsinki after the emergency medical call centre organization reform in Finland.</p> <p>Methods</p> <p>A retrospective observational study was conducted in the EMCC in southern Finland. The data from the former system, which had municipality-based centers, covered the years 2002-2005 and was collected from several databases. From the new EMCC, data was collected from January 1 to May 31, 2006. Identified performance indicators were used to evaluate and compare the old and new EMCC organizations.</p> <p>Results</p> <p>A total of 67 610 emergency calls were analyzed. Of these, 54 026 were from the municipality-based centers and 13 584 were from the new EMCC. Compared to the old municipality-based centers the new EMCC dispatched the highest priority to 7.4 percent of the calls compared to 3.6 percent in the old system. The high priority cases not detected by dispatchers increased significantly (p < 0.001) in the new EMCC organization, and the identification rate of unexpected deaths in the dispatched ambulance assignments was not significantly (p = 0.270) lower compared to the old municipality-based center data.</p> <p>Conclusion</p> <p>After implementation of a new EMCC organization in Finland the percentage and number of high priority calls increased. There was a trend, but no statistically significant increase in the emergency medical dispatchers' ability to detect patients with life-threatening conditions despite structured education, regular evaluation and standardization of protocols in the new EMCC organization.</p

Cost-efficient evaluation of ambulance services for community critical care transport needs in Machakos County, Kenya

Background: Machakos County is one of the 47 counties in Kenya. In the current study performance of ambulance services were measured using indicators such as response time, on-scene time, clients’ satisfaction and cost-efficiency (technical).Objectives: To determine the cost-efficient ambulance services appropriate for community critical care transport needs in Machakos County.Design: Descriptive cross sectional study.Setting: Machakos County (Emergencies Services Department)Subjects: Publically financed ambulancesResults: Machakos has seventy Basic Life Support (BLS) ambulances distributed among the 69 administrative locations (wards). A total of 12,674 victims were transported to different tares of hospital and referrals between March 2014 to May 2015. Victims requiring emergency obstetric care (EMOC) accounted for 24.7% of victims transported, road traffic accidents victims10.3% and the least were rape victims at 0.03%. The annual operational cost was Kshs. 70,328,627 (USD 717,639.05). Expenditure profiles indicated that staff wages accounted for 49% of total operational cost,overheads costs accounted for 33.5%, while office rent accounted for 1.36%. The mean unit cost per kilometer was Kshs. 30.9 (USD 0.32) and cost per victim transported by an ambulance was Kshs. 6,504 (USD 66.37). Key demand factors were social cultural and health seeking behaviours of residents. The supply barriers were transport costs, operational costs and in-efficient signage on roads for direction. The mean cost-efficiency (technical) of Machakos ambulance transport services was 90.6% (C.I 82.7% - 98.2%).Conclusion: Machakos County Government ambulance services was technically efficient operating

Current State of the Art Historic Building Information Modelling

In an extensive review of existing literature a number of observations were made in relation to the current approaches for recording and modelling existing buildings and environments: Data collection and pre-processing techniques are becoming increasingly automated to allow for near real-time data capture and fast processing of this data for later modelling applications. Current BIM software is almost completely focused on new buildings and has very limited tools and pre-defined libraries for modelling existing and historic buildings. The development of reusable parametric library objects for existing and historic buildings supports modelling with high levels of detail while decreasing the modelling time. Mapping these parametric objects to survey data, however, is still a time-consuming task that requires further research. Promising developments have been made towards automatic object recognition and feature extraction from point clouds for as-built BIM. However, results are currently limited to simple and planar features. Further work is required for automatic accurate and reliable reconstruction of complex geometries from point cloud data. Procedural modelling can provide an automated solution for generating 3D geometries but lacks the detail and accuracy required for most as-built applications in AEC and heritage fields

Iowa Plan for Trauma System Development 2022-2027, April 2023

The State Trauma Plan will: • Guide comprehensive system development • Address system operational requirements • Allow for local trauma system variations based on assessment results (e.g., rural versus urban needs and resources) • Reflect inclusiveness of the operational components as they fall under assessment, policy development, and assuranc

Preventable deaths presenting to a level 1 trauma centre in South Africa : a panel study

Includes bibliographical references.The aim of our study was to identify areas for quality improvement in regards to preventable trauma deaths at Groote Schuur Hospital Trauma Centre (GSHTC)

2022 Iowa Trauma Registry Report, December 2023

The 2022 Iowa Trauma Registry Report is the product of an analytics project on data reported to the Iowa Trauma Registry, including reporting on inpatient and outpatient events. Additionally, this report contains data analyzed from Iowa death certificates and the Center for Disease Control and Prevention’s (CDC) available death statistics. This report can be helpful to users interested in understanding Iowa’s trauma system, data driven decision-making related to the trauma system, process improvement related to the trauma system, and the reduction of morbidity and mortality from trauma