Bridging the Gap: Utilizing a Pediatric Trauma Coordinator to Reduce Disparities for Pediatric Trauma Follow-up Care
Christina McRoberts, RN1; Nie Bohlen, MSN, RN2; Hale E. Wills, MD, MS, FACS, FAAP3
1Hasbro Children's Hospital, Providence, RI; 2Rhode Island Hospital, Providence, RI; 3Hasbro Children's Hospital/Alpert Medical School of Brown University, Providence, RI
Background: A Level I Pediatric Trauma Center found a lack in centralized resources led some multi-system trauma patients to experience gaps and an increase in resource utilization for trauma follow-up care. A Pediatric Trauma Coordinator (PTC) began working with patients and families to navigate the healthcare system post-hospital discharge to reduce barriers to care. The impact of this initiative is reported here.
Methods: New trauma registry processes were implemented to capture long-term outcomes for the following cohorts: 1.) patients who have a traumatic brain injury finding on CT scan and one injury in another body region; and 2.) patients with injuries in > three body regions. Data sets from the 12 month pre-implementation and 8 month post-implementation periods were compared.
Results: Fourteen patients were identified in the pre-implementation period, and six patients in the post-implementation period. (Table I.) The pre-implementation group had an average Injury Severity Score (ISS) of 22 with a rate of 14% for injury-related Emergency Department (ED) visits and readmissions within 30 days. The post-implementation cohort had an average ISS of 23 with a rate of 0% for the same data elements.
Conclusions: Close follow-up by a PTC decreased injury-related ED visits and hospital readmissions within 30 days of discharge for multi-system trauma patients. Establishing a systematic approach to identify gaps for follow-up care can be effective. Long-term findings warrant further study.
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