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Published in: Journal of Trauma Management & Outcomes 1/2014

Open Access 01-12-2014 | Research

Routinely recorded versus dedicated time registrations during trauma work-up

Authors: Joanne C Sierink, Evin WM de Jong, Niels WL Schep, J Carel Goslings

Published in: Journal of Trauma Management & Outcomes | Issue 1/2014

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Abstract

Introduction

Since time intervals are used to determine quality of trauma care, it is relevant to know how reliable those intervals can be measured. The aim of our study was to assess the reliability of time intervals as recorded in our hospital databases.

Patients and methods

We conducted a prospective study on time intervals in our level-1 trauma centre and compared those with the routinely recorded data from February 2012 to June 2012. A convenience sample of all trauma patients admitted to our trauma room was included. The routinely recorded time intervals were retrieved from computerised hospital databases. The dedicated time registration was done on a standardised form on which five time intervals considered clinically relevant were evaluated for each patient by a dedicated person: trauma room time, time to start CT, imaging time, time from trauma room to ICU and time from trauma room to intervention.

Results

In a sample of 100 trauma patients dedicated registered trauma room time was median 47 minutes (IQR = 32-63), compared to 42 minutes (IQR = 28-56) in routinely recorded in hospital databases (P < 0.001). Time to start of CT scanning differed significantly as well, with again an increased time interval measured dedicatedly (median 20 minutes (IQR = 15-28)) compared to the routinely recorded time registration (median 13 minutes (IQR = 4-21)). The other time intervals recorded did not differ between the dedicated and routinely recorded registration. Bland-Altman plots also showed that there is considerable discrepancy between the two measurement methods with wide limits of agreement.

Conclusion

This study shows that routinely recorded time intervals in the trauma care setting differ statistically significant from dedicatedly registered intervals.
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Literature
1.
go back to reference Lerner EB, Moscati RM: The golden hour: scientific fact or medical “urban legend”?. Acad Emerg Med. 2001, 8: 758-760. 10.1111/j.1553-2712.2001.tb00201.x.CrossRefPubMed Lerner EB, Moscati RM: The golden hour: scientific fact or medical “urban legend”?. Acad Emerg Med. 2001, 8: 758-760. 10.1111/j.1553-2712.2001.tb00201.x.CrossRefPubMed
2.
go back to reference John F, Karen G, Clay Mann N, Melanie N, Paige N, Dagan W: ACS NTDB National Trauma Data Standard Data Dictionary. National Trauma Data Bank. 2015, 59-80. John F, Karen G, Clay Mann N, Melanie N, Paige N, Dagan W: ACS NTDB National Trauma Data Standard Data Dictionary. National Trauma Data Bank. 2015, 59-80.
3.
go back to reference Stelfox HT, Bobranska-Artiuch B, Nathens A, Straus SE: Quality indicators for evaluating trauma care: a scoping review. Arch Surg. 2010, 145: 286-295. 10.1001/archsurg.2009.289.CrossRefPubMed Stelfox HT, Bobranska-Artiuch B, Nathens A, Straus SE: Quality indicators for evaluating trauma care: a scoping review. Arch Surg. 2010, 145: 286-295. 10.1001/archsurg.2009.289.CrossRefPubMed
4.
go back to reference Stelfox HT, Straus SE, Nathens A, Bobranska-Artiuch B: Evidence for quality indicators to evaluate adult trauma care: a systematic review. Crit Care Med. 2011, 39: 846-859. 10.1097/CCM.0b013e31820a859a.CrossRefPubMed Stelfox HT, Straus SE, Nathens A, Bobranska-Artiuch B: Evidence for quality indicators to evaluate adult trauma care: a systematic review. Crit Care Med. 2011, 39: 846-859. 10.1097/CCM.0b013e31820a859a.CrossRefPubMed
5.
go back to reference Evans C, Howes D, Pickett W, Dagnone L: Audit filters for improving processes of care and clinical outcomes in trauma systems. Cochrane Database Syst Rev. 2009, 4: CD007590 Evans C, Howes D, Pickett W, Dagnone L: Audit filters for improving processes of care and clinical outcomes in trauma systems. Cochrane Database Syst Rev. 2009, 4: CD007590
6.
go back to reference Di Bartolomeo S, Valent F, Rosolen V, Sanson G, Nardi G, Cancellieri F, Barbone F: Are pre-hospital time and emergency department disposition time useful process indicators for trauma care in Italy?. Injury. 2007, 38: 305-311. 10.1016/j.injury.2006.10.005.CrossRefPubMed Di Bartolomeo S, Valent F, Rosolen V, Sanson G, Nardi G, Cancellieri F, Barbone F: Are pre-hospital time and emergency department disposition time useful process indicators for trauma care in Italy?. Injury. 2007, 38: 305-311. 10.1016/j.injury.2006.10.005.CrossRefPubMed
7.
go back to reference Shafi S, Nathens AB, Parks J, Cryer HM, Fildes JJ, Gentilello LM: Trauma quality improvement using risk-adjusted outcomes. J Trauma. 2008, 64: 599-604. 10.1097/TA.0b013e31816533f9.CrossRefPubMed Shafi S, Nathens AB, Parks J, Cryer HM, Fildes JJ, Gentilello LM: Trauma quality improvement using risk-adjusted outcomes. J Trauma. 2008, 64: 599-604. 10.1097/TA.0b013e31816533f9.CrossRefPubMed
8.
go back to reference Glance LG, Dick AW, Mukamel DB, Osler TM: Association between trauma quality indicators and outcomes for injured patients. Arch Surg. 2012, 147: 308-315. 10.1001/archsurg.2011.1327.CrossRefPubMed Glance LG, Dick AW, Mukamel DB, Osler TM: Association between trauma quality indicators and outcomes for injured patients. Arch Surg. 2012, 147: 308-315. 10.1001/archsurg.2011.1327.CrossRefPubMed
9.
go back to reference American College of Surgeons Committee on Trauma: ATLS Advanced Trauma Life Support Program for Doctors. 2008, Chigago, IL: Student Course Manual American College of Surgeons Committee on Trauma: ATLS Advanced Trauma Life Support Program for Doctors. 2008, Chigago, IL: Student Course Manual
10.
go back to reference Sierink JC, Saltzherr TP, Beenen LF, Luitse JS, Hollmann MW, Reitsma JB, Edwards MJ, Hohmann J, Beuker BJ, Patka P, Suliburk JW, Dijkgraaf MG, Goslings JC: A multicenter, randomized controlled trial of immediate total-body CT scanning in trauma patients (REACT-2). BMC Emerg Med. 2012, 12: 4-10.1186/1471-227X-12-4.CrossRefPubMedPubMedCentral Sierink JC, Saltzherr TP, Beenen LF, Luitse JS, Hollmann MW, Reitsma JB, Edwards MJ, Hohmann J, Beuker BJ, Patka P, Suliburk JW, Dijkgraaf MG, Goslings JC: A multicenter, randomized controlled trial of immediate total-body CT scanning in trauma patients (REACT-2). BMC Emerg Med. 2012, 12: 4-10.1186/1471-227X-12-4.CrossRefPubMedPubMedCentral
11.
go back to reference Fung Kon Jin PH, Goslings JC, Ponsen KJ, Van KC, Hoogerwerf N, Luitse JS: Assessment of a new trauma workflow concept implementing a sliding CT scanner in the trauma room: the effect on workup times. J Trauma. 2008, 64: 1320-1326. 10.1097/TA.0b013e318059b9ae.CrossRefPubMed Fung Kon Jin PH, Goslings JC, Ponsen KJ, Van KC, Hoogerwerf N, Luitse JS: Assessment of a new trauma workflow concept implementing a sliding CT scanner in the trauma room: the effect on workup times. J Trauma. 2008, 64: 1320-1326. 10.1097/TA.0b013e318059b9ae.CrossRefPubMed
12.
go back to reference Saltzherr TP, Bakker FC, Beenen LF, Dijkgraaf MG, Reitsma JB, Goslings JC: Randomized clinical trial comparing the effect of computed tomography in the trauma room versus the radiology department on injury outcomes. Br J Surg. 2012, 99 (Suppl 1): 105-113.CrossRefPubMed Saltzherr TP, Bakker FC, Beenen LF, Dijkgraaf MG, Reitsma JB, Goslings JC: Randomized clinical trial comparing the effect of computed tomography in the trauma room versus the radiology department on injury outcomes. Br J Surg. 2012, 99 (Suppl 1): 105-113.CrossRefPubMed
13.
go back to reference Bland JM, Altman DG: Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986, 1: 307-310.CrossRefPubMed Bland JM, Altman DG: Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986, 1: 307-310.CrossRefPubMed
14.
go back to reference Helm M, Kulla M, Fischer S, Lampl L: Trauma watch. A modular concept of data reporting following major trauma. Notfall & Rettungsmedizin. 2012, 7: 328-333. Helm M, Kulla M, Fischer S, Lampl L: Trauma watch. A modular concept of data reporting following major trauma. Notfall & Rettungsmedizin. 2012, 7: 328-333.
15.
go back to reference Drazen E, Rhoads J: Using Tracking Tools to Improve Patient Flow in Hospitals, Issue Brief. California HealthCare Foundation. 2011, 4: 1- Drazen E, Rhoads J: Using Tracking Tools to Improve Patient Flow in Hospitals, Issue Brief. California HealthCare Foundation. 2011, 4: 1-
Metadata
Title
Routinely recorded versus dedicated time registrations during trauma work-up
Authors
Joanne C Sierink
Evin WM de Jong
Niels WL Schep
J Carel Goslings
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Journal of Trauma Management & Outcomes / Issue 1/2014
Electronic ISSN: 1752-2897
DOI
https://doi.org/10.1186/1752-2897-8-11

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