Grant: Partnerships for Health System Improvement (PHSI)

<html> <body> <p>Unnecessary medical care costs Canadians $56 billion per year and increases patient mortality and morbidity. Trauma represents one of the most resource-intensive medical specialties with enormous potential for improvements in efficiency. However, only one study has evaluated costs for injury admissions in a universal health system and <b>no study has been designed to adequately assess the complex relationship between resource use and quality of care</b>. To improve the efficiency and effectiveness of injury care, information on the association between resource use intensity and quality of care is urgently required. <b>In direct response to this knowledge gap, we will identify aspects of resource use intensity that drive high quality care and those with no clinical benefit. First</b>, we will estimate resource use for injury admissions using activity-based costing and identify hospital, physician, and patient determinants of high resource use. <b>Second</b>, we will derive and validate a hospital indicator of resource use intensity based on risk-adjusted mean costs. <b>Third</b>, we will assess the multi-dimensional association between resource use intensity and injury care quality (structure, process and outcome) to identify aspects of resource use related to high quality care and those with no clinical benefit.<br> <br> This project will rapidly achieve low-cost deliverables because the Qu&eacute;bec provincial Institute for health care excellence (<i>INESSS)</i> will provide us with exclusive free access to all required data. We will produce information on the costs of acute injury care that is not yet available in Canada and provide stakeholders with a tool to monitor resource use intensity for injury admissions. In the short term, the resource use indicator will be integrated into provincial and national trauma systems. In the medium term, results will lead to the implementation of interventions to improve injury care resource use. <b>This project will improve the effectiveness and efficiency of acute injury care thus reducing the economical and societal burden of injury in Canada</b>. The project has been designed and will be performed in close collaboration with key stakeholders including <i>INESSS</i>, the <i>Trauma Association of Canada</i>, and <i>Accreditation Canada</i>.<br> <br> <b>The project team has been chosen to ensure the feasibility of the program and maximise its potential to improve national and international health care systems</b>. The nominated PI is a <i>CIHR</i> new investigator working in close collaboration with national and international injury organizations to develop tools to improve the quality and efficiency of injury care. She has expertise in the development, implementation and assessment of quality indicators, risk adjustment, multi-level modelling and data quality. The principal knowledge-user (KU) is director of the <i>INESSS</i> trauma program, mandated to optimize quality in the Qu&eacute;bec trauma system. Other KU are executive presidents of the <i>Trauma Association of Canada</i> and <i>Accreditation Canada.</i> Co-investigators include key injury researchers and KU across Canada, the USA, and Australia with a documented commitment to improving global injury care. They have clinical expertise in emergency medicine, surgery, and critical care and methodological expertise in health economics, healthcare management, health informatics, causal inference, knowledge translation (KT), and healthcare quality. The research team has strong links with policy-makers, clinical associations, and patient/family representatives<i>.</i> </p> </body> </html>