• Sandra Montmany, Jose L Pascual, Patrick K Kim, Janet McMaster, Anna Pallisera, Pere Rebasa, Alexis Luna, and Salvador Navarro.
• Hospital Universitari Parc Taulí, Sabadell, Barcelona, España. Electronic address: sandra.montmany@gmail.com.
• Cir Esp. 2017 Oct 1; 95 (8): 457-464.

IntroductionThe aim is comparing the quality of care at a typical American trauma center (USC) vs. an equivalent European referral center in Spain (SRC), through the analysis of preventable and potentially preventable deaths.MethodsComparative study that evaluated trauma patients older than 16 years old who died during their hospitalization. We cross-referenced these deaths and extracted all deaths that were classified as potentially preventable or preventable. All errors identified were then classified using the JC taxonomy.ResultsThe rate of preventable and potentially preventable mortality was 7.7% and 13.8% in the USC and SRC respectively. According to the JC taxonomy, the main error type was clinical in both centers, due to errors in intervention (treatment). Errors occurred mostly in the emergency department and were caused by physicians. In the USC, 73% of errors were therapeutic as compared to 59% in the SRC (P=.06). The SRC had a 41% of diagnosis errors vs just 18% in the USC (P = .001). In both centers, the main cause of error was human. At the USC, the most frequent human cause was 'knowledge-based' (44%). In contrast, at the SRC center the most common errors were 'rule-based' (58%) (P<.001).ConclusionsThe use of a common language of errors among centers is key in establishing benchmarking standards. Comparing the quality of care of an American trauma center and a Spanish referral center, we have detected remarkably similar avoidable errors. More diagnostic and 'ruled-based' errors have been found in the Spanish center.Copyright © 2017. Publicado por Elsevier España, S.L.U.

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