TRAUMA AUDIT - CLOSING THE LOOP

The philosophy of medical audit and methods of data collection and sta tistical analysis have been extensively reviewed but less has been wri tten about the effect of audit on medical practice. The measurement of performance is only valuable if it identifies areas of concern and st imulates appropriate change. This paper describes the work of the Salf ord Trauma Audit Group which has been developed at Hope Hospital, the problems that have been recognized, the strategies that have been intr oduced to effect change and their influence on management and outcome. Analysis of performance reveals an initial fall in adjusted mortality rate from severe injury after the introduction of resuscitation teams , the adherence to Advanced Trauma Life Support protocols and an integ rated multidisciplinary approach to trauma care. Problems remain and t here is continuing concern about trauma management in the hospital. Th is has been reinforced by performance feedback through the Trauma Audi t Group which has attracted the interest senior clinicians in several specialties,