A. DeLoach1, C. Coogan1, C. R. Thrush1, M. K. Kimbrough1 1University Of Arkansas For Medical Sciences,Trauma And Critical Care Surgery,Little Rock, AR, USA
Introduction: Teamwork is crucial for efficacious trauma resuscitation. Communication failure between team members can lead to negative patient outcomes, but communication can be improved through trauma briefings and team training. Though teamwork training has shown to improve performance, far less research has examined the differing perspectives among providers during trauma resuscitations. This study was designed to assess different responder’s perceptions about roles, responsibilities, and communication during trauma activations.
Methods: A brief survey was sent to all Emergency Medicine residents (n=24), General Surgery residents (n=27), and Emergency Department nurses (n=23) at a mid-size comprehensive academic health center. The survey assessed perceived effectiveness during trauma activations and also allowed for free text comments in the following categories: Interpersonal Communication, Leadership, Roles/Responsibilities, Environmental Control, Documentation, and Other.
Results: The results showed significant differences in team member perceptions in three areas: 1) noise in trauma bay negatively impacts patient care (p<0.001, Surgery<Nurses, EM<Nurses), 2) ineffective interpersonal communication by trauma team members occurring during trauma activation (p<0.05, Surgery<Nurses), and 3) confusion about the responsibilities of trauma activation participants (p<0.05 Surgery<EM). The open response comments showed uncertainty in roles and responsibilities of trauma resuscitation participants and revealed a need for more defined roles and pre-rehearsed protocols.
Conclusion: Study results highlight the importance of differing interprofessional perceptions in order to encourage collaboration, improve communication, and ensure well-defined roles in the trauma bay. As part of our performance improvement process of applying for and receiving Level 1 Trauma Center verification from the American College of Surgeons, the survey results helped inform multiple changes to improve trauma resuscitations. These changes included more defined responsibilities, posted roles, and video-recording of trauma resuscitations for review in the Emergency Department and Trauma joint Morbidity and Mortality conferences.