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Surgical checklists, multidisciplinary communication are key to improve outcomes in trauma care
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PHOENIX — Orthopedic trauma surgeons must work together to improve outcomes by implementing surgical checklists, sharing information with other disciplines and reducing costs of "overtriage" in trauma centers, according to the keynote lecturer, here.
"We need to make our practices more uniform and more standard in order to achieve more predictable outcomes," Andrew H. Schmidt, MD, president of the Orthopaedic Trauma Association, stated in his presidential address. "One way to achieve this is with the use of surgical checklists."
Schmidt noted the World Health Organization Surgical Safety Checklist as an example of the efficacy of checklists. The checklist reduced complications by one-third in hospitals in the United States, United Kingdom, Canada and New Zealand when implemented, he said. Sharing of information between various disciplines ensures meaningful information is communicated.
"By ensuring that information and responsibility are shared among a team, processes become more standardized, mistakes become less and less common and the team becomes more and more efficient," he said. "Most importantly, patient outcomes improve."
Another problem existing in trauma care involves “overtriage,” or admitting a patient with an inappropriate injury to a dedicated trauma center. Patients are also brought to hospitals where trauma care is not available and then need to be referred to a trauma center, which increases the overall cost of care that Schmidt said should be preventable.
"In our changing landscape of health care delivery, business considerations and profit motives are playing an increasingly important role and I think it is our job to make sure that our trauma systems remain intact and that medical considerations alone dictate trauma triage," Schmidt said. "We need to do it right the first time, for the sake of our patients. If care is not available at the local hospital, let’s get that patient to a person and an institution that is capable of providing definitive care with one transfer."
Reference:
Schmidt AH. Standardization and systems: Steps we must take (together). Presented at: Orthopaedic Trauma Association Annual Meeting. Oct. 9-12, 2013; Phoenix.
Disclosure: Schmidt is a paid consultant for and receives royalties from Smith & Nephew and receives royalties from CFI Medical.