Results of a multi-institutional outcome assessment: results of a structured peer review of TRISS-designated unexpected outcomes
Karmy-Jones, R.; Copes, W.S.; Champion, H.R.; Weigelt, J.; Shackford, S.; Lawnick, M.; Rozycki, G.S.; Hollingsworth-Fridlund, P.; Klein, J.
Journal of Trauma 32(2): 196-203
1992
ISSN/ISBN: 0022-5282 PMID: 1740802 Document Number: 389021
The utility of TRISS as a component of trauma center quality assurance (QA) was evaluated. TRISS survival probabilities were estimated for a total of 2,023 consecutive trauma patients admitted to three level-I trauma centers during a 6-month period. A structured peer review was performed of the 50 patients (2.1%) having statistically unexpected outcomes. For 23 (18 survivors, five deaths) TRISS-designated outcomes were sustained in peer review. In 27 cases (one survivor, 26 deaths) TRISS-designated outcomes were not sustained by peer review and TRISS. Limitations were identified in each case. Peer review of unexpected outcomes identified by TRISS provided a consistent and objective QA methodology. An understanding of TRISS as an objective component of the trauma center QA process is essential in blending it with what is, at present, a largely subjective process in many hospitals. Use of TRISS standardizes the peer review process, resulting in a more reliable base for development and improvement of trauma center QA programs.