Undertriage in trauma: an ignored quality indicator?

Area of Science:

• Trauma care systems
• Injury surveillance
• Healthcare quality indicators

Background:

• Effective trauma care necessitates early identification of life-threatening injuries to minimize morbidity and mortality.
• Norway's 2017 National Trauma Plan aims to optimize care through quality indicators, yet undertriage remains a neglected area.
• Undertriage, defined as severely injured patients not receiving trauma team attention, is a critical quality indicator with a benchmark of less than 5%.

Discussion:

• A national survey revealed that only 50% of Norwegian trauma-receiving hospitals can provide undertriage data.
• The current national trauma system is ill-equipped to collect essential data on this specific quality indicator.
• Ongoing national discussions regarding the definition of severe injury may impact future undertriage metrics.

Key Insights:

• Knowledge of undertriage is vital for enhancing patient safety and refining triage tools.
• Improved data collection on undertriage can provide valuable learning opportunities for hospitals and prehospital services.
• A significant gap exists in the reporting and utilization of undertriage data among Norwegian hospitals.

Outlook:

• Future efforts should focus on standardizing undertriage data collection and reporting across all trauma centers.
• Hospital administrators must prioritize requesting and analyzing undertriage data to drive quality improvement.
• Refining the definition of severe injury is essential for accurate undertriage assessment and improved trauma system performance.