Defining adverse events during trauma resuscitation: a modified RAND Delphi study.

Area of Science:

• Trauma Care
• Patient Safety
• Clinical Taxonomy

Background:

• Most preventable adverse events (AEs) in trauma occur during initial resuscitation.
• Inconsistent AE reporting hinders performance comparisons between trauma centers.
• A standardized system is needed to evaluate trauma resuscitation quality.

Purpose of the Study:

• To create a comprehensive taxonomy of AEs during trauma resuscitation.
• To develop a classification system for the degree of harm associated with each AE.

Main Methods:

• Modified RAND Delphi methodology with 22 multidisciplinary trauma experts.
• Systematic review to inform the preliminary list of AEs.
• Two rounds of online surveys and a consensus meeting to finalize the taxonomy and classification.

Main Results:

• A finalized taxonomy of 67 AEs in trauma resuscitation was established.
• Each AE was classified by degree of harm (Scale I-V, no harm to death).
• Consensus was defined as 80% agreement among experts.

Conclusions:

• A standardized taxonomy and harm classification for trauma resuscitation AEs has been developed.
• This taxonomy facilitates consistent evaluation of trauma care across centers.
• The system aims to improve patient safety and quality of care in trauma resuscitation.