Use of a Modified American College of Surgeons Trauma Quality Improvement Program to Enhance 30-Day Post-Trauma Readmission Detection

Shapiro, David S.; Umer, Affan; Marshall, William T.; Hansen, Kelly; Boucher, Ellen; Emmanuel, A; Ellner, Scott J.; Feeney, James M.

doi:10.1016/j.jamcollsurg.2016.02.008

Cited by 11 publications

(11 citation statements)

References 14 publications

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“…Readmissions are increasingly being scrutinized by public insurers, accountable care 1 organizations, and the American College of Surgeons [1][2][3][4][5][6][7]. Trauma readmissions have been promoted as a quality indicator [2,5,8], and they have been used as a metric to compare patient care approaches and hospital outcomes [9][10][11][12]. Published work has largely focused on adult trauma patient readmissions [5,8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24].…”

Section: Introductionmentioning

confidence: 99%

“…Trauma readmissions have been promoted as a quality indicator [2,5,8], and they have been used as a metric to compare patient care approaches and hospital outcomes [9][10][11][12]. Published work has largely focused on adult trauma patient readmissions [5,8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. A number of those studies are limited to single institutions that do not track readmissions at different hospitals [13,14,16,19,21].…”

Section: Introductionmentioning

confidence: 99%

“…A number of those studies are limited to single institutions that do not track readmissions at different hospitals [13,14,16,19,21]. The readmission studies that have included pediatric trauma patients have described readmissions to the same institutions [25][26][27][28], and these may underestimate pediatric trauma readmissions [5,29]. Among adult trauma patients in California, only 55% of the readmissions were in the same hospital as the index admission [12].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

US pediatric trauma patient unplanned 30-day readmissions

Wheeler

Shi

Xiang

et al. 2018

Journal of Pediatric Surgery

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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US pediatric trauma patient unplanned 30-day readmissions

Wheeler

Shi

Xiang

et al. 2018

Journal of Pediatric Surgery

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“…One of the programs of the World Health Organization (WHO) focuses on violence and injury prevention, 1 as trauma is a major cause of death and disability all over the world. [2][3][4] Preventable causes of trauma-related mortality are uncontrolled blood loss and trauma-induced coagulopathy (TIC). 5,6 Both need to be immediately identified and treated as recommended by the European Trauma Treatment Guidelines (ETTG) 2016.…”

mentioning

confidence: 99%

Point-of-Care Coagulation Monitoring in Trauma Patients

Stein

Kaserer

Spahn

et al. 2017

Semin Thromb Hemost

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Trauma remains one of the major causes of death and disability all over the world. Uncontrolled blood loss and trauma-induced coagulopathy represent preventable causes of trauma-related morbidity and mortality. Treatment may consist of allogeneic blood product transfusion at a fixed ratio or in an individualized goal-directed way based on point-of-care (POC) and routine laboratory measurements. Viscoelastic POC measurement of the developing clot in whole blood and POC platelet function testing allow rapid and tailored coagulation and transfusion treatment based on goal-directed, factor concentrate-based algorithms. The first studies have been published showing that this concept reduces the need for allogeneic blood transfusion and improves outcome. This review highlights the concept of goal-directed POC coagulation management in trauma patients, introduces a selection of POC devices, and presents algorithms which allow a reduction in allogeneic blood product transfusion and an improvement of trauma patient outcome.

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“…Thus, the rate at which trauma patients return to an emergency department (ED) soon after discharge remains high. Prior investigations have identified that up to 14% of injured patients return to an ED within 30 days of their discharge [4][5][6][7][8]. The accuracy of this data is in question, as many patients do not return to the index hospital [5].…”

Section: Introductionmentioning

confidence: 99%

Victims of Violence and Post-Discharge Adverse Events: A Prospective Modified Trauma Quality Improvement Program (TQIP) Study

Gontarz¹,

Siddiqui²,

McGuiness³

et al. 2021

Cureus

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IntroductionTrauma patients frequently return to an emergency department (ED) soon after discharge; often for nonurgent reasons. Social factors contribute to higher ED usage. At present, there is no standardized system for reporting of ED visits and readmissions among trauma care. We hypothesized that victims of violent crime suffer from many early post-discharge adverse events that has not been captured by current methods. MethodsWe prospectively consented and enrolled injured patients from January 1st, 2019 to December 31st, 2019. We documented 30-day post-discharge events using post-discharge phone calls and detailed chart abstraction. Patients were categorized as victims of violence (VV) or unintentional traumatic injury (UT). ResultsDuring the study period, 444 patients were enrolled. Fifty-one (11.5%) were victims of violence and 393 (88.5%) experienced unintentional injuries. The VV patients were younger (40.10 vs 60.36; p<0.0001), and more predominantly male (92.16% vs 57.51%; p<0.0001). Total injury severity score (ISS), critical care length of stay (LOS), and total LOS were similar. VV patients were more likely discharged home (70.59% vs 55.47%; p=0.0403). They were significantly more likely to return to an emergency department (47.06% vs 23.16%; p<0.0005) and had more total number of ED visits per patient. Readmission rates, however, were not different (21.57% vs 16.28%; p=NS). The VV patients more frequently were underinsured (72.5%, vs 20.6%, p<0.005). DiscussionVictims of violence presented to the ED significantly more often, despite similar injury scores, LOS, and being of younger age. Of these patients, only 26.2% of ED presentations resulted in readmission, suggesting the majority of patient complaints may have been able to be managed in an office-based setting. VV had significantly more underinsured or subsidized patients. Victims of violence are vulnerable and may benefit from more resources provided in the early post-discharge period.

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Use of a Modified American College of Surgeons Trauma Quality Improvement Program to Enhance 30-Day Post-Trauma Readmission Detection

Cited by 11 publications

References 14 publications

US pediatric trauma patient unplanned 30-day readmissions

US pediatric trauma patient unplanned 30-day readmissions

Point-of-Care Coagulation Monitoring in Trauma Patients

Victims of Violence and Post-Discharge Adverse Events: A Prospective Modified Trauma Quality Improvement Program (TQIP) Study

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