OBJECTIVE: To determine the efficacy and safety of a two-tier trauma response, using prehospital criteria for matching trauma center assets with severity of injury. DESIGN: A prospective iterative study on a consecutive sample of patients to test the hypothesis. MATERIAL AND METHODS: Criteria were developed whereby in-hospital response was determined by information provided by prehospital personnel. Two modifications of these criteria were introduced at 6 and 9 months. Triage and response accuracy were evaluated using outcome variables. Cost savings were estimated using differences between the full and modified teams. Chi-squared analysis was used. MEASUREMENTS AND MAIN RESULTS: Of 1,479 patients evaluated over a 9-month period, 682 (46%) received a full trauma team response, and a modified trauma team responded to 794 (54%). When compared with final designation by outcome variables, the sensitivity, specificity, and accuracy were significantly improved after the first modification of criteria. After the second modification, there was no significant improvement; however, the number of undertriaged patients increased significantly. Estimated cost savings were about $178,000 over the 9-month period. CONCLUSIONS: Utilization of a two-tier response to trauma patients is effective, safe, and results in substantial cost savings.
OBJECTIVE: To determine the efficacy and safety of a two-tier trauma response, using prehospital criteria for matching trauma center assets with severity of injury. DESIGN: A prospective iterative study on a consecutive sample of patients to test the hypothesis. MATERIAL AND METHODS: Criteria were developed whereby in-hospital response was determined by information provided by prehospital personnel. Two modifications of these criteria were introduced at 6 and 9 months. Triage and response accuracy were evaluated using outcome variables. Cost savings were estimated using differences between the full and modified teams. Chi-squared analysis was used. MEASUREMENTS AND MAIN RESULTS: Of 1,479 patients evaluated over a 9-month period, 682 (46%) received a full trauma team response, and a modified trauma team responded to 794 (54%). When compared with final designation by outcome variables, the sensitivity, specificity, and accuracy were significantly improved after the first modification of criteria. After the second modification, there was no significant improvement; however, the number of undertriaged patients increased significantly. Estimated cost savings were about $178,000 over the 9-month period. CONCLUSIONS: Utilization of a two-tier response to traumapatients is effective, safe, and results in substantial cost savings.
Authors: E Brooke Lerner; Amy L Drendel; Richard A Falcone; Keith C Weitze; Mohamed K Badawy; Arthur Cooper; Jeremy T Cushman; Patrick C Drayna; David M Gourlay; Matthew P Gray; Manish I Shah; Manish N Shah Journal: J Trauma Acute Care Surg Date: 2015-03 Impact factor: 3.313
Authors: Joshua B Brown; E Brooke Lerner; Jason L Sperry; Timothy R Billiar; Andrew B Peitzman; Francis X Guyette Journal: J Trauma Acute Care Surg Date: 2016-09 Impact factor: 3.313
Authors: Johanna M M Nijboer; Corry K van der Sluis; Pieter U Dijkstra; Hendrik-Jan Ten Duis Journal: Eur J Trauma Emerg Surg Date: 2008-03-18 Impact factor: 3.693
Authors: Marius Rehn; Torsten Eken; Andreas Jorstad Krüger; Petter Andreas Steen; Nils Oddvar Skaga; Hans Morten Lossius Journal: Scand J Trauma Resusc Emerg Med Date: 2009-01-09 Impact factor: 2.953