A Prospective Study of the Performance of the Trauma Team Leader

Sugrue, Michael; Seger, Maria; Kerridge, Ross; Sloane, D.; Deane, Susannah

doi:10.1097/00005373-199501000-00021

Cited by 84 publications

(60 citation statements)

References 22 publications

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“…19 , 20 Some argue that the team should be led by a surgeon, 19,20 while others believe anyone trained in trauma management can provide adequate care, and the team leader should rotate between various specialists. 21,22,23 Interestingly, we find that even though the team leader differs in the French and U.S. systems, mortality remained the same. This has implications for optimal allocation of resources, especially in areas where surgeon availability is low.…”

Section: Discussionmentioning

confidence: 64%

Comparative Effectiveness of Inhospital Trauma Resuscitation at a French Trauma Center and Matched Patients Treated in the United States

et al. 2013

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Objective The objective of this paper is to compare mortality outcomes between patients treated at a trauma center in France and matched patients in the United States. Summary Background Data Although trauma systems in France and the U.S. differ significantly in pre-hospital and in-hospital management, previous comparisons have been challenged by lack of comparable data. Methods Coarsened exact matching identified matching patients between a single center trauma database from Lyon, France and the National Trauma Data Bank (NTDB) of the U.S. Moderate to severely injured (ISS >8) adult patients (age ≥16) presenting alive to level-1 trauma centers from 2002–2005 with blunt or penetrating injuries were included. After matching patients, multivariate regression analyses were performed to determine difference in mortality between patients in Lyon and the NTDB. Results A total of 1,043 significantly injured patients presented to the Lyon center. Matching eligible patients with complete records were sought from 219,985 patients in the NTDB. The unadjusted odds of mortality at the Lyon center was 2.5 times higher than that of the NTDB (95% CI =2.18, 2.98). However, the Lyon center received patients with higher ISS, lower GCS and lower SBP (all p<0.001). After 1:1 matching 858 patient pairs were produced, and the odds of mortality became equivalent (OR= 1.3, 95% CI =0.91, 1.73). Similar results were found on multiple subset analyses. Conclusions Trauma patients admitted to a single French trauma center had an equal chance of survival compared to similarly injured patients treated at U.S. trauma centers.

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Section: Discussionmentioning

confidence: 64%

Comparative Effectiveness of Inhospital Trauma Resuscitation at a French Trauma Center and Matched Patients Treated in the United States

et al. 2013

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“…This is due in part to expert groups such as the Institute of Medicine and regulators like the Joint Commission for Accreditation of Health-care Organizations who advocate some type of team training. In addition, research suggests the need for improved teamwork and communication in neonatal intensive care, 2,3,16 emergency departments, 10 the operating room, 17,18 trauma resuscitation [19][20][21] and among residents of all disciplines. 22 Despite this interest and research, two recent reviews concluded that no studies have shown that team training can improve teamwork and the quality of care, 11,12 and a cluster randomized trial of team training for labor and delivery teams did not find significant changes in the process of care or outcome measures.…”

Section: Discussionmentioning

confidence: 99%

Teaching teamwork during the Neonatal Resuscitation Program: a randomized trial

et al. 2007

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Objective: To add a team training and human error curriculum to the Neonatal Resuscitation Program (NRP) and measure its effect on teamwork. We hypothesized that teams that received the new course would exhibit more teamwork behaviors than those in the standard NRP course.Study design: Interns were randomized to receive NRP with team training or standard NRP, then video recorded when they performed simulated resuscitations at the end of the day-long course. Outcomes were assessed by observers blinded to study arm allocation and included the frequency or duration of six team behaviors: inquiry, information sharing, assertion, evaluation of plans, workload management and vigilance. IntroductionThe Neonatal Resuscitation Program (NRP) is the standard curriculum used to teach caregivers how to treat newborns in the delivery room. Worldwide, the NRP could improve outcomes of thousands of newborns per year. 1 However, approximately 30% of NRP steps are not performed or performed incorrectly, 2,3 and pediatric residents often fail to intubate infants correctly. 4 Neonatal resuscitation should be a team activity that involves at least two people who work together to achieve a shared goal. 5 Breakdowns in teamwork may contribute to the quality problems noted above. For example, team behaviors are correlated with the quality of neonatal resuscitation, 3 communication breakdowns are root cause of 72% of perinatal deaths and injuries, 6 perceptions of effective teamwork are correlated with less burnout and fewer delays in labor and delivery, 7 and there is broad consensus from expert groups and researchers that measuring and improving teamwork will help improve the quality of health care. [8][9][10] However, none of the nine lessons in the NRP textbook 1 includes instruction about teamwork, in part because no studies have shown that team training can improve either teamwork or the quality of health care. 11,12 Therefore, we conducted a study with two specific aims: (1) to incorporate teamwork skills and information about human error into the 1-day NRP training program for interns and (2) to randomize interns to this new version of NRP or the standard NRP and measure the effects on teamwork during the simulated resuscitations at the end of the day. We hypothesized that it would be feasible to add the teamwork training to the 1-day NRP course, and that interns who were randomized to the NRP course with team training would exhibit more teamwork behaviors during the simulated resuscitation than would the interns in the standard NRP course.

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“…5 A training course, therefore, has to cover these topics in theory and in practice, as has been shown previously. 9,14 Simultaneously, targeted individual skills and competency training, as the ATLS and similar courses, has to take place in parallel with team training. In Norway, these training modalities are seen as complementary and not competitive.…”

Section: Discussionmentioning

confidence: 99%