Closed-Loop Communication Improves Task Completion in Pediatric Trauma Resuscitation.

Area of Science:

• Medical Communication
• Trauma Care
• Patient Safety

Background:

• Effective communication is critical in time-sensitive pediatric trauma care.
• Aviation and healthcare have adopted structured communication strategies (e.g., TeamSTEPPS) to prevent errors.
• Closed-loop communication, a key component of structured communication, warrants evaluation in pediatric trauma settings.

Purpose of the Study:

• To evaluate the impact of closed-loop communication on time-to-task completion during pediatric trauma activations.
• To assess whether pre-notification or activation level influences task completion times.

Main Methods:

• Prospective observational study of 89 pediatric trauma activations.
• Video recording and independent review of verbal orders for audibility, directed responsibility, and check-back.
• Analysis of time-to-task completion, pre-notification, and activation level using SAS 9.4.

Main Results:

• 387 verbal orders were analyzed; 26.1% utilized closed-loop communication.
• Closed-loop communication significantly reduced time-to-task completion (p < 0.0001), with orders completed 3.6 times faster.
• Pre-notification and trauma team activation level did not significantly impact time-to-task completion.

Conclusions:

• Closed-loop communication enhances efficiency in pediatric trauma resuscitation.
• Training programs for trauma team leaders should incorporate closed-loop communication strategies.
• Implementing structured communication can improve the speed and effectiveness of pediatric trauma care.