Association Between Compliance with Triage Directions from an Organized State Trauma System and Trauma Outcomes

Benjamin Martinez, John T Owings, Christopher Hector, Paige Hargrove, Shoichiro Tanaka, Margaret Moore, Patrick Greiffenstein, Joseph Giaimo, Shahrzad Talebinejad, John P. Hunt

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background The Louisiana Emergency Response Network (LERN), a statewide trauma system, has a single communication center with real-time data on hospital capacity across the state. With these data, scene information, and a standardized triage protocol, prehospital providers are directed to the most appropriate hospital. The purpose of our study was to compare outcomes between those patients who complied with the LERN communication center direction and those who did not. Study Design Trauma patients directed by LERN from the field in 2014 were included. Patients who followed the LERN communication center direction were considered the compliant group. Patients brought to a hospital inconsistent with the LERN direction were considered the noncompliant group. Chi-square analysis was used to compare differences between groups and a p value of <0.05 was considered statistically significant. Results During the study period, LERN directed 14,071 patients to a destination hospital. Prehospital providers were compliant with the LERN direction in 13,037 (92.7%) patients and noncompliant in 1,034 (7.3%) patients. There were fewer patients in the compliant group (570 of 13,037 [4.3%]) requiring transfer to a second hospital than in the noncompliant group (312 of 1,034 [30.2%]) (p < 0.01). The mortality rate was lower in the compliant group (81 of 13,037 [0.6%]) than in the noncompliant group (21 of 1,034 [2.03%]) (p < 0.01). Conclusions Following direction from a central communication center with real-time hospital capacity data yielded a 6-fold decrease in secondary transfer and a 3-fold decrease in mortality. These data emphasize the value of an organized statewide trauma network that routes patients to the appropriate facilities.

Original languageEnglish (US)
Pages (from-to)508-515
Number of pages8
JournalJournal of the American College of Surgeons
Volume225
Issue number4
DOIs
StatePublished - Oct 1 2017
Externally publishedYes

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Triage
Emergencies
Wounds and Injuries
Communication
Direction compound
Mortality

ASJC Scopus subject areas

  • Surgery

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Association Between Compliance with Triage Directions from an Organized State Trauma System and Trauma Outcomes. / Martinez, Benjamin; Owings, John T; Hector, Christopher; Hargrove, Paige; Tanaka, Shoichiro; Moore, Margaret; Greiffenstein, Patrick; Giaimo, Joseph; Talebinejad, Shahrzad; Hunt, John P.

In: Journal of the American College of Surgeons, Vol. 225, No. 4, 01.10.2017, p. 508-515.

Research output: Contribution to journalArticle

Martinez, B, Owings, JT, Hector, C, Hargrove, P, Tanaka, S, Moore, M, Greiffenstein, P, Giaimo, J, Talebinejad, S & Hunt, JP 2017, 'Association Between Compliance with Triage Directions from an Organized State Trauma System and Trauma Outcomes', Journal of the American College of Surgeons, vol. 225, no. 4, pp. 508-515. https://doi.org/10.1016/j.jamcollsurg.2017.06.016
Martinez, Benjamin ; Owings, John T ; Hector, Christopher ; Hargrove, Paige ; Tanaka, Shoichiro ; Moore, Margaret ; Greiffenstein, Patrick ; Giaimo, Joseph ; Talebinejad, Shahrzad ; Hunt, John P. / Association Between Compliance with Triage Directions from an Organized State Trauma System and Trauma Outcomes. In: Journal of the American College of Surgeons. 2017 ; Vol. 225, No. 4. pp. 508-515.
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abstract = "Background The Louisiana Emergency Response Network (LERN), a statewide trauma system, has a single communication center with real-time data on hospital capacity across the state. With these data, scene information, and a standardized triage protocol, prehospital providers are directed to the most appropriate hospital. The purpose of our study was to compare outcomes between those patients who complied with the LERN communication center direction and those who did not. Study Design Trauma patients directed by LERN from the field in 2014 were included. Patients who followed the LERN communication center direction were considered the compliant group. Patients brought to a hospital inconsistent with the LERN direction were considered the noncompliant group. Chi-square analysis was used to compare differences between groups and a p value of <0.05 was considered statistically significant. Results During the study period, LERN directed 14,071 patients to a destination hospital. Prehospital providers were compliant with the LERN direction in 13,037 (92.7{\%}) patients and noncompliant in 1,034 (7.3{\%}) patients. There were fewer patients in the compliant group (570 of 13,037 [4.3{\%}]) requiring transfer to a second hospital than in the noncompliant group (312 of 1,034 [30.2{\%}]) (p < 0.01). The mortality rate was lower in the compliant group (81 of 13,037 [0.6{\%}]) than in the noncompliant group (21 of 1,034 [2.03{\%}]) (p < 0.01). Conclusions Following direction from a central communication center with real-time hospital capacity data yielded a 6-fold decrease in secondary transfer and a 3-fold decrease in mortality. These data emphasize the value of an organized statewide trauma network that routes patients to the appropriate facilities.",
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AU - Owings, John T

AU - Hector, Christopher

AU - Hargrove, Paige

AU - Tanaka, Shoichiro

AU - Moore, Margaret

AU - Greiffenstein, Patrick

AU - Giaimo, Joseph

AU - Talebinejad, Shahrzad

AU - Hunt, John P.

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N2 - Background The Louisiana Emergency Response Network (LERN), a statewide trauma system, has a single communication center with real-time data on hospital capacity across the state. With these data, scene information, and a standardized triage protocol, prehospital providers are directed to the most appropriate hospital. The purpose of our study was to compare outcomes between those patients who complied with the LERN communication center direction and those who did not. Study Design Trauma patients directed by LERN from the field in 2014 were included. Patients who followed the LERN communication center direction were considered the compliant group. Patients brought to a hospital inconsistent with the LERN direction were considered the noncompliant group. Chi-square analysis was used to compare differences between groups and a p value of <0.05 was considered statistically significant. Results During the study period, LERN directed 14,071 patients to a destination hospital. Prehospital providers were compliant with the LERN direction in 13,037 (92.7%) patients and noncompliant in 1,034 (7.3%) patients. There were fewer patients in the compliant group (570 of 13,037 [4.3%]) requiring transfer to a second hospital than in the noncompliant group (312 of 1,034 [30.2%]) (p < 0.01). The mortality rate was lower in the compliant group (81 of 13,037 [0.6%]) than in the noncompliant group (21 of 1,034 [2.03%]) (p < 0.01). Conclusions Following direction from a central communication center with real-time hospital capacity data yielded a 6-fold decrease in secondary transfer and a 3-fold decrease in mortality. These data emphasize the value of an organized statewide trauma network that routes patients to the appropriate facilities.

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