Trauma Division - Continuous Quality Improvement (CQI)

The purpose of continuous quality improvement:

• Create a system of optimal care for all trauma patients
• Measure, evaluate, and improve the quality and effectiveness of care
• Assure trauma standards of care are met and inappropriate variations of care are minimized
• Prevent and decrease death and disability

CQI is a requirement of Senate Bill 1554 (2004): "The Oklahoma Trauma Systems Improvement and Development Act"

This legislation created the:

• Medical Audit Committee
• Regional Continuous Quality Improvement Committees

The Regional CQI Committees are sub-committees of the RTABs (Regional Trauma Advisory Boards). These committees are made up of representatives from Hospitals, EMS Services, Air Services and Physicians. The various roles of the committee members help to deliver a multi-faceted perspective on cases reviewed. The Regional CQI Committees are tasked with review of quality related issues that occur in the Region which are system or process related.

What is the purpose of a REFERRAL?

• R-Review of what happened
• E-Ensure expeditious and expert care was given
• F-Formulate a time-line of events
• E-Examine reasoning for decisions
• R-Regional Plans/T3 Algorithms/patient priority (application of)
• R-Recommendations from Committee
• A-Action is required!
• L-Loop closure letters (how the required actions are communicated)

Recommendations for improvement may include but are not limited to the following elements:

• COMMUNICATION!
• Application of the Trauma Triage and Transport Guidelines
• Application of the Regional Trauma Plan
• Consideration of destination choices of ground units (based on the Regional Plan) and the effects on the Critical access and Level 4 facilities when delivering multiple injured patients to the same facility
• Ground ALS support
• Utilization of air at the scene
• PELA sites
• Do not perform testing at Critical access and level 4 facilities when the conditions discovered cannot be treated or managed at the facility. Priority 1 patients should be brought to these facilities for stabilization ONLY
• EDUCATION! EDUCATION! EDUCATION! TNCC (Trauma Nursing Core Course), RTTDC Rural Trauma Team Development Course, ATLS (Advanced Trauma Life Support), Education on Regional Plans and T3 Algorithms

It is imperative that all patient care providers know what resources are available in their area. Hospitals, EMS Services, Air services, EMRAs (Emergency Medical Responders) and local first responders should meet together to discuss the best plan of action when responding to trauma scenes in their area. This communication fosters a team approach and will ensure the patient receives the best possible coordinated care, when help is needed.

"The time to plan for an Emergency is before it happens!"

The goal of the State Trauma System is to deliver the best care possible to the Citizens of Oklahoma. This can only be accomplished when, collectively, we work together towards this goal.

Do you have a trauma care concern or issue? Submit a referral for review.

**Send confidential documents to secure fax at (405) 900-7561 or email to 4059007561@xmedius.com.

Emergency Systems
Oklahoma State Department of Health
123 Robert S Kerr Ave, Suite 1702
Oklahoma City, OK 73102-6406
Office: (405) 426-8480
Fax: (405) 900-7560 or 4059007560@Xmedius.com (using email)
Esystems@health.ok.gov