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The impact of trauma case management on patient outcomes
Kate Curtis1, Darren Lien, Adam Chan
1Department of Emergency Medicine and Trauma, St George Hospital, Kogarah, New South Wales, Australia. curtisk@sesahs.nsw.gov.au
Background:
Previous investigations demonstrate that nursing case management in the acute care setting improves patient outcomes. However, these findings provide limited information specific to trauma patients.
Method:
The effect of trauma case management (TCM) was measured using practice-specific variables such as in-hospital complications, missed injury rates, and length of stay. Other measures included staff satisfaction and use of allied health services. Data from 148 patients with an Injury Severity Score < 16 in the 5 months after the introduction of TCM were compared with 327 patients from the previous 12 months.
Results:
Results demonstrated a trend toward reduced length of stay overall, more so in the older and more severely injured. TCM greatly improved missed injury detection rates (p < 0.0015) and coordinated allied health use more efficiently (p < 0.0001). Staff surveys exhibited a perceived dramatic improvement in the effectiveness of patient care (p < 0.0001).
Conclusion:
The introduction of TCM improved the efficiency and effectiveness of trauma patient care in our institution.