Clinical practice guideline adherence during Operation Inherent Resolve

Plackett, Timothy P.; Cherry, Darren C.; Delk, Gerald; Satterly, Steven; Theler, Jared; McVay, Derek P.; Moore, Jacqueline; Shackelford, Stacy

doi:10.1097/ta.0000000000001473

Cited by 12 publications

(9 citation statements)

References 13 publications

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“…Of the publications classified as operational use (n = 61, 42%), 51 publications [ 16 – 66 ] investigated whether program participation or implementation of an intervention was associated with improved quality of care as measured by a composite indicator. In 10 publications [ 67 – 76 ] the primary aim was to measure hospital performance and/or changes in performance over time ( Table 3 ).…”

Section: Resultsmentioning

confidence: 99%

Composite measures of quality of health care: Evidence mapping of methodology and reporting

et al. 2022

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Background Quality indicators are used to quantify the quality of care. A large number of quality indicators makes assessment of overall quality difficult, time consuming and impractical. There is consequently an increasing interest for composite measures based on a combination of multiple indicators. Objective To examine the use of different approaches to construct composite measures of quality of care and to assess the use of methodological considerations and justifications. Methods We conducted a literature search on PubMed and EMBASE databases (latest update 1 December 2020). For each publication, we extracted information on the weighting and aggregation methodology that had been used to construct composite indicator(s). Results A total of 2711 publications were identified of which 145 were included after a screening process. Opportunity scoring with equal weights was the most used approach (86/145, 59%) followed by all-or-none scoring (48/145, 33%). Other approaches regarding aggregation or weighting of individual indicators were used in 32 publications (22%). The rationale for selecting a specific type of composite measure was reported in 36 publications (25%), whereas 22 papers (15%) addressed limitations regarding the composite measure. Conclusion Opportunity scoring and all-or-none scoring are the most frequently used approaches when constructing composite measures of quality of care. The attention towards the rationale and limitations of the composite measures appears low. Discussion Considering the widespread use and the potential implications for decision-making of composite measures, a high level of transparency regarding the construction process of the composite and the functionality of the measures is crucial.

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Section: Resultsmentioning

confidence: 99%

Composite measures of quality of health care: Evidence mapping of methodology and reporting

et al. 2022

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“…Despite this high crystalloid use, a gradual decrease in mean volumes transfused was reported as a result of changes in crystalloid transfusion paradigms. The unexplained preference of crystalloid based resuscitation over resuscitation using blood products was also by Plackett et al 29 in a series of 114 trauma patients who were treated in a role 2 facility. Of 108 patients who required volume resuscitation, crystalloids were the initial fluid of choice in 76%, despite guidelines instructing the use of blood products as the initial resuscitation fluid.…”

Section: Crystalloid Transfusionmentioning

confidence: 87%

Trends in combat casualty care following the publication of clinical practice guidelines

Nadler

Tsur

Lipsky

et al. 2021

J Trauma Acute Care Surg

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BACKGROUND:The current study explores the trends in the application of combat casualty care following the publication of clinical practice guidelines (CPGs) in five domains for 13 years. METHODS:The Israel Defense Forces Trauma Registry was used to assess practice and adherence to guidelines in five domains: (a) crystalloid transfusions, (b) tranexamic acid use, (c) freeze-dried plasma use, (d ) chest decompression, and (e) airway management. All patients injured between January 2006 and December 2018 were included in the analysis. Trends were analyzed and presented monthly using linear regression and were compared using the Chow test. RESULTS: The mean ± SD crystalloid volume transfused decreased from 1,179 ± 653 mL in 2006 to 466 ± 202 mL in 2018 (B = 0.016, 0.006-0.044). The proportion of patients with an indication treated with tranexamic acid dropped from 8% (238 of 2,979 patients) to 2.5% (60 of 2,356 patients) following the stricter guideline's publication. Freeze-dried plasma administration in indicated casualties rose from 12.5% in 2013 to 48% in 2018 (B = 1.63, 1.3-2.05). The overall proportion of casualties undergoing chest decompression rose from 1% (61 of 6,036 casualties) to 1.5% (155 of 10,493 casualties) following the release of a new CPG in 2012 (p = 0.013). There were no significant trends in intubation ratios before (B = 0.987, 0.953-1.02) or after 2012 (B = 10.2, 0.996-1.05). CONCLUSION:Some aspects demonstrate the desired trends in response to new CPGs; in others, initial improvement is achieved but followed by stagnation. In some medical care aspects, completely unexpected and undesirable trends are observed. Every change and update in CPGs should be based on reliable data. The effect of every change must be monitored carefully to ensure adequate adherence to lifesaving guidelines.

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“…A survey from academic hospitals showed that 60% of respondents have a single protocol for all patients. 28 Compliance with a single MHP is poor in published studies, 12,16,29 which raises the concern that consistent care would be further compromised by multiple protocols for different bleeding scenarios. The panel recommended a single, standardized protocol in response to the massively bleeding patient with options to tailor the protocol for specific patient populations.…”

Section: A Single Protocol For All Patientsmentioning

confidence: 99%

A regional massive hemorrhage protocol developed through a modified Delphi technique

Callum

Petrosoniak²,

McVey³

et al. 2019

cmajo

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assive bleeding is a leading preventable cause of death following trauma, childbirth and surgery. 1-3 There were 5.1 million deaths after traumatic injury worldwide in 2010, mostly affecting young people, accounting for nearly 10% of all deaths. 4 In the United States, it is estimated that up to 20% of such deaths are the direct result of preventable hemorrhage. 4-7 Management of unstable hemorrhagic shock is centred on stabilizing the patient with prompt transfusion of blood components, and rapid identification and treatment of the source of bleeding. Patient outcome is dependent on the availability of rapid definitive surgical intervention, support of a transfusion medicine and clinical laboratory, prompt access to hemostatic agents and care provided by a high-performing interdisciplinary team. 8 In the trauma literature, protocolized delivery of massive transfusion streamlines the complexities

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Clinical practice guideline adherence during Operation Inherent Resolve

Abstract: Epidemiologic study, level IV.

Cited by 12 publications

References 13 publications

Composite measures of quality of health care: Evidence mapping of methodology and reporting

Composite measures of quality of health care: Evidence mapping of methodology and reporting

Trends in combat casualty care following the publication of clinical practice guidelines

A regional massive hemorrhage protocol developed through a modified Delphi technique

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