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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Minimizing preventable trauma deaths in a limited-resource setting: A test-case of a multidisciplinary panel review approach at the Komfo Anokye Teaching Hospital in Ghana
World Journal of Surgery, Volume 38, No. 7, Year 2014
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Description
Objective: Our objectives were to determine the proportion of preventable trauma deaths at a large trauma hospital in Kumasi, Ghana, and to identify opportunities for the improvement of trauma care. Methods: A multidisciplinary panel of experts evaluated pre-hospital, hospital, and postmortem data of consecutive trauma patients who died over a 5-month period in 2006-2007 at the Komfo Anokye Teaching Hospital. The panel judged the preventability of each death. For preventable and potentially preventable deaths, deficiencies in care that contributed to their deaths were identified. Results: The panel reviewed 231 trauma deaths. Of these, 84 charts had sufficient information to review preventable factors. The panel determined that 23 % of trauma deaths were definitely preventable, 37 % were potentially preventable, and 40 % were not preventable. One main deficiency in care was identified for each of the 50 definitely preventable and potentially preventable deaths. The most common deficiencies were pre-hospital delays (44 % of the 50 deficiencies), delay in treatment (32 %), and inadequate fluid resuscitation (22 %). Among the 19 definitely preventable deaths, the most common cause of death was hemorrhage (47 %), and the most common deficiencies were inadequate fluid resuscitation (37 % of deficiencies in this group) and pre-hospital delay (37 %). Conclusions: A high proportion of trauma fatalities might have been preventable by decreasing pre-hospital delays, adequate resuscitation in hospital, and earlier initiation of care, including definitive surgical management. The study also showed that preventable death panel reviews are a feasible and useful quality improvement method in the study setting. © 2014 Société Internationale de Chirurgie.
Authors & Co-Authors
Yeboah, Dominic
Unknown Affiliation
Mock, Charles N.
Unknown Affiliation
Karikari, Patrick
Unknown Affiliation
Agyei-Baffour, Peter
Unknown Affiliation
Donkor, Peter
Unknown Affiliation
Ebel, Beth E.
Unknown Affiliation
Statistics
Citations: 46
Authors: 6
Affiliations: 4
Identifiers
Doi:
10.1007/s00268-014-2452-z
ISSN:
03642313
e-ISSN:
14322323
Research Areas
Health System And Policy
Study Locations
Ghana