Process mapping as a framework to define critical care delivery steps in massive transfusion in trauma

Area of Science:

• Emergency Medicine
• Quality Improvement
• Trauma Care

Background:

• Massive transfusion protocols are critical for managing hemorrhagic shock in trauma patients.
• Understanding the complexities of care delivery is essential for improving patient outcomes.

Purpose of the Study:

• To utilize process mapping to identify critical steps in massive transfusion for trauma patients.
• To inform the development of performance metrics and enhance care delivery for massive transfusions.

Main Methods:

• Employed the Institute for Healthcare Improvement framework in an academic emergency department.
• Conducted structured interviews with multidisciplinary staff and real-time observations of protocol deployment.
• Utilized process mapping to visualize the sequence and interdependencies of care delivery steps.

Main Results:

• Identified 17 interviews and 533 mapped objects, yielding 87 pages of data.
• Highlighted two key clinical decision points: initiation of transfusion and imaging.
• Segmented the process into initial protocol-based and subsequent physician-driven care phases.

Conclusions:

• Process mapping successfully established a standardized process for massive transfusion protocols.
• The created maps outline critical steps and distinct care phases for trauma patients.
• Findings provide benchmarks for future quality improvement and performance measurement initiatives.