557 Use of Online Clinical Guidelines for Burn Care in the Deployed Environment: A Model for Care in Rural or Remote Locations

Abstract

Abstract Introduction During the last decade, our national Joint Trauma System (JTS) has served as the reference body for trauma care throughout our military. The JTS has published 63 Clinical Practice Guidelines (CPGs) on its website to set standards and to provide guidance for deployed providers in the management of challenging clinical scenarios. Given that there is limited burn expertise in the military, the JTS CPGs are a major source of information for most providers. It has been possible to track CPG download activity for over a year. We hypothesized that assessment of download activity would reflect the relative value of JTS CPGs. In particular, we aimed to document the value of burn-related CPGs. Methods Download activity was determined from data pulled for jts.amedd.army.mil, utilizing Google’s Digital Analytics Program (DAP), for 27 Feb 2018 to 3 Sep 2019. After refining results from all of the military down to jts.amedd.army.mil, a search was then launched to determine the top activities on the JTS webpage. An additional refinement was conducted to establish search-date parameters. Data were exported into an Excel spreadsheet for further analysis. The data were analyzed for specific titles and numbers of downloads; those downloads consistently appearing at the top of the download activity were split out and detailed. Results Downloading was consistently the top “event” or tangible action on the site. In 17 months, total CPG downloads from the JTS website were 75,901. Burn-related CPGs and supporting documents (e.g. Lund-Browder chart; resuscitation flowsheet) were downloaded 6,177 times. The next most frequently downloaded CPG was the traumatic brain injury (TBI) CPG, which was downloaded 6,041 times. If each guideline had equal distribution of downloads, they would each be downloaded 1,205 times; burn-related CPGs were download 5 times more frequently than the mean. Conclusions This study emphasizes the importance of burn-related CPGs to providers throughout the global continuum of care. These providers frequently work in expeditionary, remote and austere environments without rapid access to specialty surgical expertise. The use of detailed CPGs can help bridge this gap. Applicability of Research to Practice This model can be used for remote rural areas nationally and internationally. Computer-based tracking of CPG and educational material downloads can, furthermore, be used to identify ongoing educational needs.