Evaluation

To ensure continuous evaluation of the trauma care continuum (TCC), INESSS developed quality and performance criteria that are used to evaluate, in an established assessment cycle, the quality and performance of each facility, consortium and centre of expertise designated as part of the Québec trauma care network (LIEN vers Bilan de qualité et de performance en traumatologie: Guide d'accompagnement). These evaluations are generated from the data in Québec’s trauma registry (Système d’information du Registre des traumatismes du Québec, SIRTQ), to which all designated facilities must contribute, and they are used in planning local continuous quality improvement activities as well provincial quality development and support initiatives. The evaluations are available on a secure website reserved for trauma care network partners.

In addition, when requested by the MSSS, INESSS’s trauma and critical care evaluation unit drafts more general portraits of the clientele and performance of the trauma care network that are used in developing more strategic guidelines for service organization and decision-making on a provincial level.

The efforts devoted to the establishment and continuous monitoring of the trauma care continuum (TCC) over close to 30 years have borne fruit. Québec studies demonstrate a 55% drop in traffic accident deaths thanks to accident and injury prevention, that is, the first two components of the TCC. In addition, in-hospital mortality rate for major trauma victims dropped from 51.8% in 1992 before the TCC was introduced to 8.6% in 2002.^1,2 An additional 24% drop in mortality was also noted between 1999 and 2012, together with a 16% drop in length of hospital stay without impact on readmission or complication rates.³ At 7%, Québec’s in-hospital mortality rate for the period from 2006 to 2012 was the lowest in Canada. These achievements have been documented in numerous publications over the years and they have been granted recognition and awards by different organizations, the following among them:

• HTAi 2016 David Hailey Award for Best Impact Story, Tokyo, 2016
• Chapter on the Québec trauma care network in the World Health Organization (WHO) report entitled. Strengthening care for the injured: Success stories and lessons learned from around the world. Geneva׃ World Health Organization, 2010.
• Report of the Auditor General of Québec - Prix d’excellence de l’administration publique du Québec 2006

For more information:

Shaping quality through vision, structure, and monitoring of performance and quality indicators: Impact story from the Quebec trauma network

1Liberman M, Mulder DS, Lavoie A, Sampalis JS. Implementation of a trauma care system: Evolution through evaluation. J Trauma 2004;56(6):1330-5.

²Sampalis JS, Denis R, Lavoie A, Frechette P, Boukas S, Nikolis A, et al. Trauma care regionalization: a process-outcome evaluation. J Trauma 1999;46(4):565-79; discussion 79-81.

3Moore L, Turgeon AF, Lauzier F, Emond M, Berthelot S, Clement J, et al. Evolution of patient outcomes over 14 years in a mature, inclusive Canadian trauma system. World J Surg 2015b;39(6):1397-405.