Amenable and preventable mortality is an indicator for evaluation of healthcare systems in general and emergency care in particular. It is derived from a conceptual thought that a good trauma system can prevent injury as a disease or decrease its negative impact on life. However, the seasonality of trauma occurrence and high operational cost of trauma centres is a deterrent for justifiable public spending, particularly when there is a resource crunch such as in Low and Medium Income Countries (LMIC). A good set of quality indicators helps in directing a process-focused system to improve the medical treatment of the patient. Having a process focus and monitoring quality metrics of the process is a commonly practiced business excellence model in the industry. Identifying and measuring such quality indicators of structure, process, and outcome for patients will be quintessential for long term sustenance of trauma programs.

Trauma registries are effective documentation of trauma programs to benchmark and continuously improve their quality of care delivery. However, a lack of standardized and uniform data collection format is a challenge in developing a good trauma registry. A poor set of indicators would often distort healthcare priorities and increase operational costs owing to high administrative expenditures.

This study aims at identifying potential indicators to evaluate the performance of the Tamil Nadu Accident and Emergency Initiative (TAEI), Paediatric Resuscitation and Emergency Medicine (PREM), and Comprehensive Emergency Obstetric and New born Care (CEmONC) programs in Tamil Nadu. Registries were built for these three flagship programs for documentation of performance quality metrics. As the first part of this study, various indicators of patients such as their evaluation, interventions, and outcome were collected and reviewed.

As the next steps, further quality indicators of patient care such as time management, process interventions, and treatment involved across pre-hospital emergency medical services, in-hospital reception & triage, in-hospital resuscitation, definitive care, rehabilitation will be collected and reviewed. The learnings of this study will help in developing a critical set of quality indicators that are relevant and actionable across the health care stakeholders. This will help to design lean, affordable, comprehensive, process-driven trauma programs for LMIC nations and states.