Comparison of quality control for trauma management between Western and Eastern European trauma center

We retrospectively reviewed a total of 182 major trauma patients treated in the two hospitals included in the study, between January and June 2002. Every case was analyzed according to the recommended minimal audit filters for trauma quality assurance by The American College of Surgeons Committee on Trauma (ACSCOT).Satisfactory yields have been reached in both centers for the management of head and abdominal trauma, airway management, Emergency Department length of stay and early diagnosis and treatment. The main significant differences between the two centers were in the patients' transfers, the leadership of trauma team and the patients' outcome. The main concerns have been in the surgical treatment of fractures, the outcome and the lacking of documentation.The analyzed hospitals are classified as Level I trauma center and are within the group of the highest quality level centers in their own countries. Nevertheless, both of them experience major lacks and for few audit filters do not reach the mmum standard requirements of ACS Audit Filters. The differences between the western and the eastern European center were slight. The parameters not reaching the minimum requirements are probably occurring even more often in suburban settings.International research on trauma is increasingly focusing on the quality improvement in the management of this emergent public health problem. The first priority for quality improving is the inter- and the intra-hospital quality control. After identifying the troublesome issues through the inter-facility control, a detailed verification of intra-facility clinical problems can give valid solutions to improve the quality of care. The quality level of a service is defined, according to Donabedian's definition, by three essential aspects: the structure, the process and the outcome. [1,2] In our study, the structures analyzed in comparison – an Italian and a Romanian Level I trauma center and their resources, are very similar.Maggiore hospi