IGEH/INRO Programs for Improvement of TBI CareW. Mauritz, M. RusnakInternational Neurotrauma Research Organizationhttp://www.igeh.org/
IGEH/INRO is a collaborative non-profit, non-governmental organization (NGO) based in Vienna, Austria, with it activities directed internationally.
MISSION Improve the recovery of patients who suffer a brain or spinal cord injury through helping hospitals implement evidence-based medical care, assisting in the reengineering of their trauma systems to better treat neurotrauma patients and collaborating on clinical research to continuously improve the scientific foundations of evidence-based guidelines and protocols.
MAKING our MISSIONa REALITY • Actively seek funding opportunities (grants, donations, corporate and government funding, etc.) to support IGEH/INRO’s mission specific projects; • Initiate, coordinate and manage funded projects and activities through out Europe and beyond, consistent with the IGEH/INRO mission
MAKING our MISSIONa REALITY • Collaborate with trauma hospitals in implementing evidence-based guidelines; • Educate and train health professionals; • Publish and disseminate information
SINCE our FOUNDINGin 1999 • Managed an International Health Care Initiative: Improving Patient Outcome from Head Injury in Central and Eastern Europe (1999 – 2001); • Developed ITCP database; • Initiated the Austrian Traumatic Brain Injury Project (In memory of Alfred von Auersperg); • Received a grant from EU 5th Framework Program on Reducing mortality and long-term disability of TBI victims through research into treatment procedures used in Bosnia-Herzegovina, Macedonia and Croatia;
SINCE our FOUNDINGin 1999 • Received a grant from British Council for exchange of scientists; • Prepared a proposal for EU COST activity (European Cooperation in the field of Scientific and Technical Research).
HEALTHCARE QUALITY is the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge Lohr KN, Harris-Wehling J. Medicare: a strategy for quality assurance. Quarterly Review Bulletin 1991;17,(1):6-9.
IMPLEMENTATION KNOWLEDGE EBM Guidelines Implementation Clinical Research
SDR External causes and poisoning Source: HFA WHO
Risk of Death in a Road Traffic Accident,1999 (% from total participating)
Brain Pressure Monitoring and Outcome in Britain Murray LS, Teasdale GM, Murray GD, Miller DJ, Pickard JD, Shaw MD. : Head injuries in four British neurosurgical centres. Br J Neurosurg. 1999 Dec;13(6):564-9.
HOSPITALS TREATING TBI in AUSTRIA • 60 hospitals treat TBI • out of them • 30 hospitals treat up to 10 patients/year • 10 hospitals treat more then 50 patients/year • Our target group of hospitals: 10 in Austria 3.75 mil. ATS/year
PROCESS of PATIENT TRANSPORT in NORTH CUMBRIA, UK Kent, A., NHS Modernization Agency, UK, 2001, personal communication
Comparison of Patient Groups Managed with Guidelines* Protocol * TBI Guidelines Adopted by AANS, USA Presented by Fakhry,SM. Inova Fairfax Hospital, Falls Church, Virginia, October 1999, at American College of Surgeons National Meeting
University of Louisville, Louisville, Kentucky Vitaz TW, McIlvoy L, Raque GH, Spain D, Shields CB.: Development and implementation of a clinical pathway for severe traumatic brain injury. J Trauma, 2001 Aug;51(2):369-75
BENEFITSOF TBI GUIDELINES PATIENT BENEFIT INSURER BENEFIT • THE MOST UP TO DATE CARE • PATIENT FAMILY ASSURED OF BEST CARE • REDUCED HOSPITAL DAYS AND COSTS • MARKED IMPROVEMENT IN PATIENT OUTCOME • LONG TERM DISABILITY DECREASED • QUALITY PRODUCT • LIABILITY • HOSPITAL COSTS • SIGNIFICANT REDUCTION IN LONG TERM COSTS
SUMMARY • EBM increases quality of care through: • Reduced costs: both acute and long term care • Reduced poor outcomes • Increased good outcomes • EBM implementation requires • Focused approach to Quality Assurance • Organization and Management of patient tracking and feedback
NEW ACTIVITIES • Developing clinical pathways and field testing • Political support for Quality improvement • Mobile technology for quality of care improvement • Strengthening of international collaboration