Measuring the Impact of Trauma in Greece: A Systematic Review of Greek Trauma Registries. Is Quality Improvement Achieva
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Measuring the Impact of Trauma in Greece: A Systematic Review of Greek Trauma Registries. Is Quality Improvement Achievable? Velmahos GC "If you can't measure it, you can't improve it" is the quote by Peter Drucker, a management philosophist who propelled the need for accurate databases and quality improvement processes in the business world. Medicine is no different. In the absence of registries that record outcomes, we are destined to repeat the errors of the past and never correct them. Trauma care in Greece is a major, probably the most important, health problem, as it affects every Greek citizen, irrespective of age, gender, or socioeconomic status. Sadly, the most dynamic and productive part of the population, including young Greeks from 1 to 45 years of age, is affected disproportionately by trauma. Despite the laudable efforts of isolated groups, trauma care is disorganized and inadequate. There is a continuum in trauma care that spans from prehospital protocols to in-hospital care, rehabilitation, and re-integration into society. To practice these steps responsibly, a national trauma system is required. The presence of trauma systems, trauma centers, and trauma teams has irrefutably proven to save lives. Unfortunately, our country has none! The authors of this important article summarize the attempt by a few, heroic, medical and epidemiological teams to capture the problem of trauma in Greece [1]. With little or no funding, with little or no governmental support, and with little or no audience to take notice, these groups have tried to create rudimentary trauma registries. Inevitably, the efforts have not led to measurable benefits and have been eventually forgotten. The current paper reminds us that two thirds of trauma patients in Greece suffer road traffic accidents or falls, and that morbidity, mortality, and process
Velmahos GC, MD, FACS, FRCS, FCCM John F. Burke Professor of Surgery, Harvard Medical School, Chief - Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, Massachusetts Corresponding author: Velmahos C George MD, FACS, FRCS, FCCM Harvard Medical School, Chief - Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, Massachusetts e-mail: [email protected] Hellenic Journal of Surgery 90
of care have never been measured in a standardized fashion. Without measurements and metrics, we cannot examine the outcomes, we cannot improve the care. Without it, more Greeks, especially young Greeks, are destined to die or be severely disabled. There is little doubt that organized trauma systems require human and financial commitment. While the human factor has never been in question, the finances are hard to commit during the current economic crisis. However, a country has to rely on its robust and healthy population to produce, advance, and prosper. When young citizens are removed from the social fabric due to preventable reasons, the prospect of national improvement is compromise
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