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Application of Donabedian Model in Trauma Centre

Donabedian framework provides for three domains to measure quality in a healthcare
facility. These three are structure, process, and outcome. The framework holds that an
improvement in structure leads to improvement in health facility’s processes which in turn leads
to better health outcomes for patients (Moore et al., 2015).
My most recent visit to a healthcare facility was a trauma facility. Regarding the first
domain – structure- the facility had excellent physical and human resources. It had all the
facilities and equipment required to treat trauma patients. As for human resources, it had highly
qualified and experienced medical personnel that included orthopedics, nurses, and physicians.
These personnel were also in sufficient numbers.
As for process, I noted that the hospital observed clinical processes for trauma patients.
These processes are 15 in total (Bradley et al., 2016). The hospital strictly followed the
established processes when dealing with patients from the time they were admitted to the
hospital to the time that they were discharged.
Lastly, patient outcomes were generally admirable when adjusted to risk such as number
of pre-existing conditions and age. For instance, there were very few unplanned readmissions
within 30 days of discharge. There were no in-hospital deaths, and few patients developed
complications such as hospital acquired pneumonia and acute respiratory failure.
Based on these observations of Donabedian triad of domains, the quality of the trauma
care was quite high. This observation validates the Donabedian model which holds that good
structures help healthcare facilities to have good clinical processes which in turn lead to better

APPLICATION OF DONABEDIAN MODEL IN TRAUMA CENTRE 3
outcomes for patients. The only area I felt needed improvement was nursing care. Compared to
other services, patients expressed relatively low satisfaction for the nursing services that the
trauma care facility provided them. I would recommend that they improve the quality of their
nursing services to better satisfy patient needs.

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References

Bradley, N. L., Au, S., & Widder, S. (2016). Quality Improvement and Trauma Quality
Indicators. In Trauma Team Dynamics (pp. 67-72). Springer, Cham.
Moore, L., Lavoie, A., Bourgeois, G., & Lapointe, J. (2015). Donabedian’s structure-process-
outcome quality of care model: validation in an integrated trauma system. Journal of
Trauma and Acute Care Surgery, 78(6), 1168-1175.