Teamwork simulation training based on a local risk and needs analysis improves the clinical care of trauma patients

Sebastian Kuhn Sebastian_kuhn@me.com

Abstract

Introduction: Trauma is the leading cause of death under the age of 40 years. Trauma accounts for approximately 9% of all death worldwide. The WHO estimates that the mortality of major trauma could be decreased by 30% by improving the care for these patients. The management of severely injured patients is an interdisciplinary and interprofessional task, with the quality of care highly dependent on optimized teamwork. As a first step, an analysis of the current problems must be conducted. To achieve an improvement in treatment quality, a new trauma team simulation course was formed with the principle that the knowledge of all team members should be included.

Methods: We conducted a local risk, medical errors and needs analysis by reviewing the information obtained by an anonymous hospital-wide trauma care feedback system, results from local trauma registry data, conclusions from trauma morbidity/mortality conferences and interdisciplinary trauma quality circle. These data formed the basis for the course design, which followed the systematics of Kern et al. The interdisciplinary course brings doctors, nurses, and technicians from anesthesia, radiology, trauma, pediatric surgery and pediatric intensive care together, with the objective of cultivating a collaborative mental model and practice for providing patient-centered trauma care. 75 medical professionals took part in the 8-hour-long trauma team simulation course. During the course we investigated the improvement of competencies. To conduct an analysis on a possible effect on clinical treatment, 50 successive trauma resuscitations directly prior, directly after and 6 months after the course were analyzed in regard to completeness of the primary survey and changes in typical missed items identified by the local analysis. This study was conducted at a level 1 trauma center.

Results: Our trauma teams showed significant improvement, both in completeness of the primary survey (67.3 to 80.0%) and improvement of typically missed items, from pre- to post-training. Statistical analysis showed statistical significance for all items (p < 0.01). However, the mid-terms analysis after 6 months showed a decrease in quality for the primary survey (completeness 72.9%) and inconsistent results for typically missed items.

Conclusion: The trauma team simulation course based on a local risk and needs analysis resulted in an improved efficiency of patient care in the trauma resuscitation short term. Regular refresher courses seem to be necessary to sustain the improved team performance over time. 
Contact Us

We're not around right now. But you can send us an email and we'll get back to you, asap.

Not readable? Change text. captcha txt

Start typing and press Enter to search