Development of quality indicators for emergency trauma services during man-made disasters: a multistage study in a military hospital

Background Quality indicators (QIs) are pivotal in improving healthcare quality for clinicians, healthcare organizations, managers, and healthcare systems. This study aimed to develop QIs of emergency trauma services during man-made disasters. Methods This multistage study, conducted in 2023, began with a systematic literature review across Web of Science, Scopus, PubMed, SID, Magiran, and Google Scholar to identify relevant QIs. These QIs were then merged, modified, deleted, and categorized through expert panel roundtable meetings based on the Donabedian model. Finally, a two-round Delphi process approved the QIs and their relative importance. Microsoft Excel was used for quantitative data analysis. Results A total of 103 QIs were approved and classified into structure ( n = 28), process ( n = 53), and outcome ( n = 22) categories. Of these QIs, 74 were derived from the literature review, 15 from the Delphi phase, and 14 from the existing guidelines and instructions. Notably, the process category was further divided into eight subcategories, including requirements, initial patient assessment, bleeding management, airway management, imaging, surgical interventions, documentation, and others. Conclusion This study established a comprehensive set of QIs to enhance trauma care quality in military hospital emergency settings during man-made disasters. These indicators provide a framework for monitoring service quality and guiding quality improvement initiatives. Further studies are needed to assess their feasibility and validity in practice and determine their potential effects on care processes and patient outcomes.