Trauma Team Activation: Accuracy of Triage When Minutes Count (Sub ID: 487235)
Lisa G. Schwing, RN1; Tyneida D. Faulkner, BSN, RN, CEN, CPEN2
1Dayton Children's Hospital, Centerville, OH; 2Dayton Children's Hospital, Miamisburg, OH
Background: Accuracy and timeliness of trauma activations are vital to patient safety. The American College of Surgeons (ACS) mandates the trauma surgeon's presence within 15 minutes of the patient's arrival 80% of the time. In 2015, at this Level II Pediatric Trauma Center, mean activation times were approximately 16 minutes and activation accuracy (over and under triage) affected 27% of trauma activations.
Methods: This evidence-based quality improvement project set out to streamline the Emergency Medical Service (EMS) intake process and improve accuracy and timeliness in trauma activations. Communication Center recordings were reviewed to identify: 1) accuracy of the appropriate team and inclusion of the necessary page details and 2) time when EMS notifies the Communication Center to time of trauma activation page. An educational curriculum was developed as an intervention for Communication Center staff. Education included: a decision tree for trauma activations and constructing EPIC templates in order to improve accurate activations.
Results: After implementation of the above intervention, the Communication Center performance revealed a reduction from 27.3% incorrect activations in 2015 to 10.7% incorrect activations in 2016. In addition, a staggering reduction in activation times of 90% was achieved. Mean activation time in January 2015 was 48.5 minutes before the intervention and 4.71 minutes post intervention In December 2016.
Conclusion: After additional focus groups analyzed present Communication Center performance and the industry standard, paramedic certification became the minimum qualification for incoming staff. Ongoing education is key as Trauma Service monitors outcomes and explores nursing involvement.
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