Abstract text (incl. references and figure legends)
Introduction: Polytrauma patients need involvement of various specialists and professionals. Uncoordinated involvement of these professionals may lead to delayed diagnostics and treatment of non-life-threatening injuries. We hypothesized that improved coordination would prevent delays.
Method: Patients with Injury Severity Score (ISS) ≥ 8 affecting >1 body region were included, patients with severe burns and patients who died within 30 days were excluded. Data was retrieved from the local trauma registry. A quality improvement (QI) project was established with an ambulatory team (ATOM) - a trauma surgeon, a rehabilitation physician and a coordinating trauma nurse. Patients were visited twice weekly during ATOM rounds, with the aim to note unresolved issues and discuss any concerns with ward personnel, as well as with the patient. A tertiary survey was performed on all patients within 24 hours of admittance, to look for undetected injuries. Patient reported experience measures (PREMs) were offered to all patients ≥ 18 years old as a survey on an iPad. Complications were registered in the local trauma register.
Results: The share of patients visited twice weekly by the ATOM and who were examined with a tertiary survey, increased to nearly 100 % and stabilized. For the subgroup of patients who were hospitalized for 4–16 days, there was a 25 % increase in ISS. There was no significant change in Length of stay (LOS), but the variation in LOS was reduced.
Discussion: Patients discharged by day 16 had on average more serious injuries than prior to the start of the project, indicating that the project lead to more time-efficient treatment of severely injured patients, probably due to better coordination of involved specialists.
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