Improving Massive Transfusion Protocol Response in the Rural Level III Trauma Center Setting

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Health Systems Management

Background:

• Massive transfusion protocols (MTPs) in rural Level III trauma centers face challenges like blood delivery delays, limited support, and product waste.
• Existing MTP research primarily focuses on higher-level trauma centers, leaving rural settings understudied.
• Process breakdowns, including staffing gaps and delivery delays, necessitated a targeted MTP response system.

Purpose of the Study:

• To evaluate the effectiveness of a newly implemented MTP activation response system.
• To assess improvements in resource delivery, team coordination, and documentation within a rural Level III trauma center.
• To identify persistent challenges in communication and workflow despite system improvements.

Main Methods:

• A quality improvement project utilizing a descriptive design with qualitative methods.
• Conducted at two rural Midwestern Level III trauma centers from August 2023 to February 2024.
• Data collected via anonymous online questionnaires from interdisciplinary team members post-MTP activation, analyzed using descriptive and narrative analysis.

Main Results:

• 35 team members responded across eight MTP activations.
• Key barriers identified: inaccurate paging (50%), communication challenges (62.5%), and rapid infuser issues (50%).
• Positive outcomes included appropriate calcium administration (87.5%) and high documentation compliance (89% unit documentation, 83% order confirmation).

Conclusions:

• A structured, multidisciplinary MTP response system enhances resource delivery, team coordination, and documentation in rural Level III trauma centers.
• Despite improvements, communication and workflow challenges remain significant barriers.
• Further refinement of MTP response systems is needed to optimize care in rural trauma settings.