Surgeon- and System-Based Influences on Trauma Mortality

Abstract

In a structured trauma program, there is no mortality difference between novice surgeons and their experienced trauma director. The organized trauma program and senior surgical mentoring overpower any influence of individual surgeon inexperience.

The impact of specialist trauma service on major trauma mortality

“…These reductions correlate well with the improvements seen in other countries, 20,21 indicating that the trauma service system is having a positive effect within the Australian environment.…”

Improved Prophylaxis and Decreased Rates of Preventable Harm With the Use of a Mandatory Computerized Clinical Decision Support Tool for Prophylaxis for Venous Thromboembolism in Trauma

“…24 These data and our baseline compliance rate suggest that trauma patients may be getting VTE prophylaxis at higher rates than other medical and surgi- cal patients. 5,6 Perhaps a well-defined protocol for trauma care, which has been shown to improve outcomes in trauma, 25,26 also helps to increase compliance with VTE prophylaxis. In our study, we observed nearly a 2-fold improvement in prophylaxis orders among patients with no contraindications to enoxaparin.…”

Blood Culture Contaminants in a Paediatric Population: Retrospective study from a tertiary hospital in Oman

“…6,11 A well-resourced trauma system is known to improve mortality rates. [13][14][15][16][17] However, the trauma system in Oman has not kept pace with modernisation and rapid population growth in the country. Furthermore, a non-holistic approach has led to a lack of integration of trauma care services within the existing healthcare system; for example, as the pre-hospital trauma care system has developed faster than existing hospital systems, there can be a decline in care once the patient is transferred to a medical facility.…”

“…20 Konvolinka et al also affirmed that increased surgeon experience with seriously injured patients was associated with improved outcomes while Haut et al reported that surgeons with vastly different levels of training could safely provide trauma care and obtain equivalent patient outcomes. 15,21 Based on these findings, it seems that more emphasis should be placed on building a cohesive trauma system rather than focusing on capacitybuilding individual components within the system. As such, all components in a hospital trauma system require equal development to assure that a satisfactory level of trauma care is provided, including institutional policies governing clinical and operational processes, round-the-clock availability of a structured trauma team, a dedicated trauma admitting unit and adequate training and qualification standards for healthcare providers involved in trauma care and the provision of essential equipment and services.…”