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An initiative to assess and improve the resources and patient care processes used among Chest Wall Injury Society
Evert A Eriksson1, Amanda Waite, SarahAnn S Whitbeck
1From the Department of Surgery (E.A.E., A.W.), Medical University of South Carolina; Chest Wall Injury Society (S.S.W.); Department of Surgery (J.A.B., W.B.D), Riverside Methodist Hospital; Department of Surgery (Z.M.B., L.C.), University of Nebraska Medicine; Department of Surgery (K.D., B.P.), Gold Coast Health; Department of Surgery (A.R.D.), St Francis Hospital and Medical Center; Department of Cardiothoracic Surgery (J.G.E.), Sheffield Teaching Hospitals NHS Foundation; Department of Surgery (J.D.F., J.T.), Stanford University; Department of Surgery (A.J.K., A.H.), Overland Park Regional Medical Center; Department of Surgery (J.G., B.W.T.), Atrium Health Carolinas Medical Center; Department of Surgery (J.H.), Westmead Hospital University of Sydney; Department of Surgery (C.J.), University of Cincinnati; Department of Surgery (S.K., B.S.), The George Washington University; Department of Surgery (E.E.M., F.P.), Denver Health Medical Center; Department of Surgery (S.D.S.), University of California, Irvine; Department of Surgery (G.S.), Wright State University; Department of Surgery, Trauma Research Unit (E.M.M.V.L., M.M.E.W.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Surgery (T.W.W.), Intermountain Healthcare; and Department of Surgery (M.E.W.), Royal Brisbane & Women's Hospital.
Background:
Over the last two decades, the acute management of rib fractures has changed significantly. In 2021, the Chest Wall injury Society (CWIS) began recognizing centers that epitomize their mission as CWIS Collaborative Centers. The primary aim of this study was to determine the resources, surgical expertise, access to care, and institutional support that are present among centers.
Methods:
A survey was performed including all CWIS Collaborative Centers evaluating the resources available at their hospital for the treatment of patients with chest wall injury. Data about each chest wall injury center care process, availability of resources, institutional support, research support, and educational offerings were recorded.
Results:
Data were collected from 20 trauma centers resulting in an 80% response rate. These trauma centers were made up of 5 international and 15 US-based trauma centers. Eighty percent (16 of 20) have dedicated care team members for the evaluation and management of rib fractures. Twenty-five percent (5 of 20) have a dedicated rib fracture service with a separate call schedule. Staffing for chest wall injury clinics consists of a multidisciplinary team: with attending surgeons in all clinics, 80% (8 of 10) with advanced practice providers and 70% (7 of 10) with care coordinators. Forty percent (8 of 20) of centers have dedicated rib fracture research support, and 35% (7 of 20) have surgical stabilization of rib fracture (SSRF)-related grants. Forty percent (8 of 20) of centers have marketing support, and 30% (8 of 20) have a web page support to bring awareness to their center. At these trauma centers, a median of 4 (1-9) surgeons perform SSRFs. In the majority of trauma centers, the trauma surgeons perform SSRF.
Conclusion:
Considerable similarities and differences exist within these CWIS collaborative centers. These differences in resources are hypothesis generating in determining the optimal chest wall injury center. These findings may generate several patient care and team process questions to optimize patient care, patient experience, provider satisfaction, research productivity, education, and outreach.
Level Of Evidence:
Therapeutic/Care Management; Level V.
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