Effect of team training on efficiency of trauma care in a Chinese hospital

J Int Med Res. 2018 Jan;46(1):357-367. doi: 10.1177/0300060517717401. Epub 2017 Jun 29.

Abstract

Objective Multidisciplinary trauma teams are the standard of care in the USA, but staffing differences and lack of advanced trauma life support training hinder replication of this system in Chinese hospitals. We investigated the effect of simulation team training on initial trauma care. Methods Over 15 months, we compared grade I trauma patients cared for by the trained team and those cared for using traditional practice on times from emergency room arrival to tests/procedures. Propensity-score analysis was performed to improve between-group comparisons. Results During the study, 144 grade I trauma patients were treated. Trained team patients showed shorter times from emergency room arrival to initiation of hemostasis (31.0 [13.5-58.5] vs. 113.5 [77-150.50] min), blood routine report (8 [5-10.25] vs. 13 [10-21] min), other blood tests (21 [14.75-25.75] vs. 31 [25-37] min), computed tomography scan (29.5 [20.25-65] vs. 58.5 [30.25-71.25] min) and tranexamic acid administration (31 [13-65] vs. 90 [65-200] min). Similar results were obtained for the propensity-score matched cohort. Conclusion Simulation team training could help reduce time to blood routine reports, scans and hemostasis. Assessment of available resources and development of targeted team training could improve care in resource-limited hospitals.

Keywords: Chinese hospital; Trauma care; before-and-after design; emergency department; grade I trauma; simulation team training.

MeSH terms

  • Adult
  • China
  • Emergency Service, Hospital*
  • Female
  • Hematologic Tests
  • Hemostasis
  • Hospitals*
  • Humans
  • Male
  • Middle Aged
  • Patient Care Team / organization & administration*
  • Retrospective Studies
  • Simulation Training*
  • Time Factors
  • Tomography, X-Ray Computed
  • Tranexamic Acid / therapeutic use
  • Trauma Centers*
  • Trauma Severity Indices
  • Workforce
  • Wounds and Injuries / diagnostic imaging
  • Wounds and Injuries / pathology
  • Wounds and Injuries / therapy*

Substances

  • Tranexamic Acid