A quality-improvement approach to effective trauma team activation

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Quality Improvement Science

Background:

• Trauma team activation (TTA) is critical for patient outcomes.
• A Canadian Level 1 trauma center experienced low TTA compliance (<60%) for major trauma.
• This indicated a significant undertriage issue.

Purpose of the Study:

• To implement a quality improvement project to increase TTA compliance.
• To achieve a sustained TTA compliance rate of at least 90%.
• To align with Accreditation Canada guidelines for trauma care.

Main Methods:

• A structured quality improvement process was employed.
• Baseline data and root-cause analysis involving stakeholders were conducted.
• Rapid change cycles focusing on structure and process, with ongoing audits, were implemented.

Main Results:

• TTA compliance increased from 58.8% to over 90% within 2 years.
• Statistically significant reductions were observed in time to CT scan and emergency department lengths of stay.
• Improved TTA compliance correlated with better patient flow metrics.

Conclusions:

• A defined quality improvement process effectively enhanced TTA compliance to over 90%.
• The established methodology provides a replicable framework for other institutions.
• Sustained improvements in trauma care processes, including TTA, are achievable.