Development of the major trauma case review tool

Area of Science:

• Trauma Care
• Patient Safety
• Clinical Review Tools

Background:

• Significant gaps exist in recommended care for major traumatic injuries, leading to preventable mortality.
• Current trauma case review lacks standardized tools addressing system safety and human factors.
• A need exists for a comprehensive process to monitor and review patient care effectively.

Purpose of the Study:

• To develop and validate an evidence-informed trauma case review tool.
• To facilitate clinical review of pediatric trauma patient care.
• To extract information for monitoring, driving change, and closing the loop in trauma care.

Main Methods:

• Iterative development of the tool based on a literature review of trauma audit tools.
• Utilized a consensus approach for tool design and refinement.
• Assessed inter-rater agreement for pilot and finalized versions of the tool.

Main Results:

• The finalized tool comprises ten sections, covering patient factors, care delivery issues, and outcomes.
• Key components include patient factors, presenting problem, timeline, contributing factors (equipment, environment, staff, organization), and outcomes.
• Improved inter-rater reliability, with an average 86% agreement on human factors and outcome components after refinement.

Conclusions:

• An evidence-informed tool was developed for pediatric trauma case review.
• The tool integrates system safety and human factors to enhance clinical review.
• It can identify improvement opportunities and guide quality assurance, with validation needed in adults.