Funnel plots a graphical instrument for the evaluation of population performance and quality of trauma care: a blueprint of implementation.

Background: Using patient outcomes to monitor medical centre performance has become an essential part of modern health care. However, classic league tables generally inflict stigmatization on centres rated as "poor performers", which has a negative effect on public trust and professional morale. In the present study, we aim to illustrate that funnel plots, including trends over time, can be used as a method to control the quality of data and to monitor and assure the quality of trauma care.

Severe isolated injuries have a high impact on resource use and mortality: a Dutch nationwide observational study.

Purpose: The Berlin poly-trauma definition (BPD) has proven to be a valuable way of identifying patients with at least a 20% risk of mortality, by combining anatomical injury characteristics with the presence of physiological risk factors (PRFs). Severe isolated injuries (SII) are excluded from the BPD. This study describes the characteristics, resource use and outcomes of patients with SII according to their injured body region, and compares them with those included in the BPD.

Modification of the TRISS: simple and practical mortality prediction after trauma in an all-inclusive registry.

Purpose: Numerous studies have modified the Trauma Injury and Severity Score (TRISS) to improve its predictive accuracy for specific trauma populations. The aim of this study was to develop and validate a simple and practical prediction model that accurately predicts mortality for all acute trauma admissions.

Methods: This retrospective study used Dutch National Trauma Registry data recorded between 2015 and 2018.

The Detrimental Impact of the COVID-19 Pandemic on Major Trauma Outcomes in the Netherlands: A Comprehensive Nationwide Study.

Objective: To evaluate the impact of the COVID-19 pandemic on the outcome of major trauma patients in the Netherlands.

Summary Background Data: Major trauma patients highly rely on immediate access to specialized services, including ICUs, shortages caused by the impact of the COVID-19 pandemic may influence their outcome.

Methods: A multi-center observational cohort study, based on the Dutch National Trauma Registry was performed.

Dutch trauma system performance: Are injured patients treated at the right place?

Background: The goal of trauma systems is to match patient care needs to the capabilities of the receiving centre. Severely injured patients have shown better outcomes if treated in a major trauma centre (MTC). We aimed to evaluate patient distribution in the Dutch trauma system.

Evaluation of the Berlin polytrauma definition: A Dutch nationwide observational study.

Background: The Berlin polytrauma definition (BPD) was established to identify multiple injury patients with a high risk of mortality. The definition includes injuries with an Abbreviated Injury Scale score of ≥3 in ≥2 body regions (2AIS ≥3) combined with the presence of ≥1 physiological risk factors (PRFs). The PRFs are based on age, Glasgow Coma Scale, hypotension, acidosis, and coagulopathy at specific cutoff values.

The Dutch nationwide trauma registry: The value of capturing all acute trauma admissions.

Introduction: Twenty years ago the Dutch trauma care system was reformed by the designating 11 level one Regional trauma centres (RTCs) to organise trauma care. The RTCs set up the Dutch National Trauma Registry (DNTR) to evaluate epidemiology, patient distribution, resource use and quality of care. In this study we describe the DNTR, the incidence and main characteristics of Dutch acutely admitted trauma patients, and evaluate the value of including all acute trauma admissions compared to more stringent criteria applied by the national trauma registries of the United Kingdom and Germany.

Waiting in the Accident and Emergency Department: Exploring Problematic Experiences.

Objectives: To investigate the relation between perceived waiting times and patients' overall ratings of accident and emergency departments (A&Es) and to explore which patients view waiting times as problematic.

Methods: A cross-sectional survey was held in 21 A&Es in the Netherlands. From each A&E, a random sample of patients was investigated.

A comparison of the quality of care in accident and emergency departments in England and the Netherlands as experienced by patients.

Background: Measuring patients' experiences to determine health-care performance and quality of care from their perspective can provide valuable evidence for international improvements in the quality of care. We compare patients' experiences in Accident & Emergency departments (A&E) in England and the Netherlands and discuss the usefulness of this comparison.

Methods: A cross-sectional survey was conducted among patients attending A&Es aged 18 years and older.

The Consumer Quality Index in an accident and emergency department: internal consistency, validity and discriminative capacity.

Background: Patients' experiences are an indicator of health-care performance in the accident and emergency department (A&E). The Consumer Quality Index for the Accident and Emergency department (CQI A&E), a questionnaire to assess the quality of care as experienced by patients, was investigated. The internal consistency, construct validity and discriminative capacity of the questionnaire were examined.

The Consumer Quality index (CQ-index) in an accident and emergency department: development and first evaluation.

Background: Assessment of patients' views are essential to provide a patient-centred health service and to evaluating quality of care. As no standardized and validated system for measuring patients' experiences in accident and emergency departments existed, we have developed the Consumer Quality index for the accident and emergency department (CQI A&E).

Methods: Qualitative research has been undertaken to determine the content validity of the CQI A&E.

Safety and efficiency of triaging low urgent self-referred patients to a general practitioner at an acute care post: an observational study.

Objective: To assess the safety and efficiency of triaging low urgent self-referred patients at the emergency department (ED) to a general practitioner (GP) based on the Manchester triage system (MTS).

Methods: All self-referred patients in the evening, night and weekends were included in this prospective observational study. Patients were triaged by an ED nurse according to the MTS and allocated to a GP or the ED according to a predefined care scheme.

Pain assessments at triage with the Manchester triage system: a prospective observational study.

Objective: Pain is one of the six general discriminators of the Manchester triage system (MTS). The frequency of pain assessments conducted at triage with the MTS, and patient, nurse and triage characteristics associated with pain assessments were studied. Also, nurses' reasons for not assessing pain at triage were studied.

An observational study of patients triaged in category 5 of the Emergency Severity Index.

Objective: Patients triaged in category 5 of the Emergency Severity Index (ESI) do not need any resources before discharge from the emergency department (ED). We studied the characteristics of these patients and focused on those who were admitted or sent to the outpatient department after their ED visit.

Methods: A retrospective observational study was conducted on 117 740 patient presentations.

Prehospital identification of major trauma patients.

Background And Aims: Prehospital triage is aimed at getting the right patient to the right hospital. Evaluations on the performance of prehospital triage tools are scarce. This study examines the ability of the American College of Surgeons' Committee on Trauma (ACSCOT) triage guidelines to identify major trauma patients in a European trauma system.

A comparison of European Trauma Registries. The first report from the EuroTARN Group.

Unlabelled: Trauma management systems have grown in response to regional variations in trauma population, geographical conditions and the provisions of care. National Trauma Registries are being established to improve patient outcomes. However international comparisons could provide the potential to record regional performance, identify and share examples of best practice.

Prehospital triage and survival of major trauma patients in a Dutch regional trauma system: relevance of trauma registry.

Background And Aims: Since 1999, the Dutch trauma care has been regionalized into ten trauma systems. This study is the first to review such a trauma system. The aim was to examine the sensitivity of prehospital triage criteria [triage revised trauma score (T-RTS)] in identifying major trauma patients and to evaluate the current level of trauma care of a regionalized Dutch trauma system for major trauma patients.

A prospective study on paediatric traffic injuries: health-related quality of life and post-traumatic stress.

Objectives: To examine children's reports of their health-related quality of life (HRQoL) following paediatric traffic injury, to explore child and parental post-traumatic stress, and to identify children and parents with adverse outcomes.

Design: Prospective cohort study.

Assessments: shortly after the injury, three months and six months post injury.

Young traffic victims' long-term health-related quality of life: child self-reports and parental reports.

Objectives: To describe the long-term health-related quality of life (HRQOL) reported by young traffic injury victims and to assess the child-parent agreement on the child's HRQOL.

Design: Cohort study with a mean follow-up of 2.4 years.

[Bicycle spoke injuries in children: accident details and consequences].

Objective: To describe the accident details and the effects of bicycle-spoke accidents on the physical and psychosocial functioning of children.

Design: Retrospective, descriptive.

Methods: The parents of 87 children aged between 1-12 who came to the central casualty department at the Groningen University Hospital with bicycle-spoke injuries during the period 1 January 1998 to 31 October 1999, were asked to complete a questionnaire on the accident details, the quality of life and the functional health status (behaviour) of their child in January 2000.

Characteristics of injured children attending the emergency department: patients potentially in need of rehabilitation.

Objective: To provide an epidemiological overview of the characteristics of injured children and to compare hospitalized and nonhospitalized injured children to identify predictors of hospitalization and, with that, possible predictors of disablement.

Design: Retrospective analysis of data obtained from a computerized trauma registration system and medical records.

Setting: Department of Traumatology, University Hospital Groningen, the Netherlands.

The health-related quality of life of pediatric traffic victims.

Objective: To describe the health-related quality of life (HRQoL) of young traffic victims and to identify those children who are at high risk of a reduced HRQoL.

Methods: Retrospective analysis of data obtained from a registration system and from questionnaires completed by 211 parents of young traffic victims who attended the department of traumatology in 1996 and 1997.

Results: The overall group of young traffic victims experienced a lower HRQoL sumscore compared with the reference population (p = 0.

Brain activation during micturition in women.

Experiments in the cat have led to a concept of how the CNS controls micturition. In a previous study this concept was tested in a PET study in male volunteers. It was demonstrated that specific brainstem and forebrain areas are activated during micturition.

A PET study on cortical and subcortical control of pelvic floor musculature in women.

The pelvic floor musculature plays an important role in behaviors such as defecation, micturition, mating behavior, and vomiting. A recent positron emission tomography (PET) study revealed that structures belonging to the emotional motor system are involved in the control of the pelvic floor during micturition. However, there also exist brain structures involved in the voluntary motor control of the pelvic floor, and the present PET study was designed to identify these structures.