Relationship between the six aims of quality in trauma care

Abstract

The Institute of Medicine (IOM) reported in 2001 that the health care system in the US fails to consistently deliver high-quality medical care. The IOM proposed six aims to be used by healthcare organizations in tracking and controlling their quality: effectiveness, efficiency, safety, timeliness, patient centeredness and equitability. Nevertheless, these quality aims are seldom considered simultaneously in research and performance improvement efforts. This research proposes a multivariate analysis approach to evaluate trauma care performance over time. Trauma quality metrics related to each aim were identified through a literature review and quantified over a six-year period using data from the Michigan Trauma Quality Improvement Program. Correlation analysis was used to investigate the relationships between quality aims. Multivariate clustering was used to identify consistently high and low-performing trauma centers. Policy-makers can use the proposed analysis approach to develop incentives for healthcare quality improvement.