What Is Trauma Performance Improvement?
Trauma performance improvement (PI) is a confidential, systematic review and discussion of trauma care with ongoing surveillance of processes, systems, and their impact on outcomes. PI is both time and data intensive and includes multiple processes.
A Brief History of Performance Improvement
The terms and focus of this process have undergone numerous changes—beginning with the term quality assurance. This evolved into total quality management, and later continuous quality improvement. Currently, trauma programs refer to the PI process as performance improvement and patient safety (PIPS). Most important, the focus has shifted away from individual provider errors to a system-wide perspective. This more sophisticated model has two fundamental concepts— “systems measures” and “human measures” that both impact patient outcome. This broader understanding of performance and quality review requires awareness that the system also contributes to error. In fact, the overall goal of building strong, resilient systems supports the delivery of safe, quality care. This foundation prevents errors from occurring and favorably impacts patient outcomes.
Just as the term has evolved, so has the trauma system’s adoption, expectation, and utilization of the PIPS process. Performance improvement for the care of the injured patient remains the central core element of Pennsylvania’s trauma system. In fact, a performance improvement and patient safety (PIPS) program is required by the Pennsylvania Trauma Systems Foundation (PTSF) Standards of Accreditation to be accredited as a trauma center.
Historically, PI has been conducted at the local, trauma facility level. As a result of health facilities merging into larger systems, the PI process has grown into a more regional process. Pennsylvania’s statewide PIPS process continues to mature and evolve with the addition of quarterly benchmark reporting, a central PI outcomes repository of state deaths, PIPS and Outcomes committees and the newly formed Pennsylvania State TQIP Collaborative (PA-TQIP) initiative.