Abstract
IntroductionOur institution uses video review as a quality improvement tool. Starting in March 2018, we specifically focused on meeting certain time goals during trauma resuscitation aimed at decreasing time to final disposition. The purpose of this study was to evaluate the effect of establishing strict time goals on total time spent in the trauma bay by pediatric trauma patients.Materials and methodsA retrospective review of all level I trauma activations at a level I pediatric trauma center between November 2017 and December 2018 was performed via manual review of the recorded trauma activations. Data on key time points such as time from arrival to transfer to gurney, to completion of primary survey, to chest x-ray, to Emergency Medical Services (EMS) report, to CT scan, and to disposition (CT or admission/operating room [OR] if no CT scan was performed) were analyzed and compared between the cohort of patients prior to implementation of the time goals with that after. The cohort of patients who presented between March 2018 and May 2018 were excluded to allow for time for the intervention to take effect.ResultsThere were 13 level I trauma activations before implementation of the time goals and 41 after. There was a significant decrease in time to transfer to gurney (1.8 minutes vs. 1.0 minutes; p=0.02), to CT scan (18.8 minutes vs. 14.2 minutes; p=0.01), and to disposition (18.3 minutes vs. 14.9 minutes; p=0.047). There was no decrease in time to completion of primary survey, EMS report, or chest x-ray.ConclusionsUtilizing video review in pediatric trauma as a quality improvement initiative with a focus on meeting specific time goals for key elements of the activation led to decreased total time in our trauma bay with critically ill patients.
Highlights
ObjectivesThe purpose of this study was to evaluate the effect of establishing strict time goals on total time spent in the trauma bay by pediatric trauma patients
Our institution uses video review as a quality improvement tool
While medical team participants in video review report provider anxiety as the main adverse effect of conducting video review, the vast majority of participants feel that it provides significant educational value [3]
Summary
The purpose of this study was to evaluate the effect of establishing strict time goals on total time spent in the trauma bay by pediatric trauma patients. The aim of this study was to evaluate the effect of creating specific time goals for key steps in a trauma activation in order to reduce the total time spent in trauma bay resuscitation of a
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