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Multiple-trauma management: standardized evaluation of the subjective experience of involved team members

Published online by Cambridge University Press:  15 September 2005

T. Gross
Affiliation:
University Hospital, Department of Surgery, Trauma Unit, Basel, Switzerland CARCAS-group, Zurich, Switzerland
F. Amsler
Affiliation:
CARCAS-group, Zurich, Switzerland
W. Ummenhofer
Affiliation:
University Hospital, Department of Anaesthesiology, Basel, Switzerland
M. Zuercher
Affiliation:
University Hospital, Department of Anaesthesiology, Basel, Switzerland
A. L. Jacob
Affiliation:
CARCAS-group, Zurich, Switzerland University Hospital, Department of Radiology, Basel, Switzerland
P. Messmer
Affiliation:
CARCAS-group, Zurich, Switzerland University Hospital, Department of Trauma Surgery, Zurich, Switzerland
R. W. Huegli
Affiliation:
CARCAS-group, Zurich, Switzerland University Hospital, Department of Radiology, Basel, Switzerland
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Summary

Background and objective: Staff attitude plays a pivotal role in quality management. The objective of the present study was to further define how interdisciplinary emergency hospital staff experience their daily work and the extent to which the professional speciality and training of an individual influences his/her assessment of multiple-trauma team performance. Methods: The clinical staff involved in multiple-trauma emergency management of a university hospital was asked to answer a confidential questionnaire. Factorial analysis was used to identify 8 major dimensions from a total of 53 items. Results: The questionnaire was returned by 128 team members. All professional groups were most dissatisfied with the dimensions ‘education and training’, ‘work sequence between specialities’ and ‘communication between specialities’. Assessment of the quality of in-hospital emergency-trauma management differed significantly between professional specialities (ANOVA, F = 5.2; P = 0.028); surgeons gave the highest ratings for all but one dimension. Having taken an Advanced Trauma Life Support (ATLS®) course influenced significantly the total rating of multiple-trauma treatments of anaesthetists and surgeons (F = 5.5; P = 0.024). Conclusions: The perceptions of interdisciplinary trauma team members without the completion of an ATLS® training course were that they did not communicate enough with each other and that there were differences between their expectations and reality. The differences and the communication deficits were overcome in team members who had passed an ATLS® course.

Type
Original Article
Copyright
© 2005 European Society of Anaesthesiology

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References

Ali J, Adam R, Butler A et al. Trauma outcome improves following the Advanced Trauma Life Support Program in a developing country. J Trauma 1993; 34: 890899.Google Scholar
Stalp M, Koch C, Ruchholtz S et al. Standardized outcome evaluation after blunt multiple injuries by scoring systems: a clinical follow-up investigation 2 years after injury. J Trauma 2003; 52: 11601168.Google Scholar
Santora T, Trooskin S, Blank C, Clarke J, Schinco M. Video assessment of trauma response: adherence to ATLS protocols. Am J Emerg Med 1996; 14: 564569.Google Scholar
Driscoll P, Nincent C. Organizing an efficient trauma team. Injury 1992; 23: 107110.Google Scholar
Helmreich R, Davies J. Human factors in the operating room: interpersonal determinants of safety, efficiency and morale. Baillières Clin Anaesth 1996; 10: 277295.Google Scholar
Sexton J, Thomas E, Helmreich R. Error, stress, and teamwork in medicine and aviation: cross sectional surveys. BMJ 2000; 320: 745749.Google Scholar
Helmreich R, Schaefer H. Team performance in the operating room. In: Bogner M, ed. Human Error in Medicine. Hillsdale, NJ: Lawrence Erlbaum Associates, 1994: 225253.
Ummenhofer W, Amsler F, Sutter P, Martina B, Martin J, Scheidegger D. Team performance in the emergency room: assessment of inter-disciplinary attitudes. Resuscitation 2001; 49: 3946.Google Scholar
Pohlenz O, Bode P. The trauma emergency room: a concept for handling and imaging the polytrauma patient. Eur J Radiol 1996; 22: 26.Google Scholar
McQuillan P, Pilkington S, Allan A et al. Confidential inquiry into quality of care before admission to intensive care. BMJ 1998; 316: 18531858.Google Scholar
Gross T, Martinoli S, Spagnoli G, Badia F, Malacrida R. Attitudes and behavior of young European adults towards the donation of organs: a call for better information. Am J Transpl 2001; 1: 7481.Google Scholar
Gross T, Marguccio I, Martinoli S. Attitudes of hospital staff involved in organ donation to the procedure. Transpl Int 2000; 13: 351356.Google Scholar
Helmreich R, Merritt A, Sherman P et al. The flight management attitudes questionnaire (FMAQ). Austin, TX, The University of Texas, 1993.
Helmreich R, Merritt A. Culture at Work in Aviation and Medicine. Aldershot, Ashgate, 1998.
Sexton J, Helmreich R, Glenn D et al. Operating room management attitudes questionnaire (ORMAQ). NASA/UT/FAA Technical Report 2000. 00-2: 112. Austin, TX, The University of Texas.
Davies H, Crombie I. Assessing the quality of care. BMJ 1995; 311: 766.Google Scholar
Kassirer J. The quality of care and the quality of measuring it. New Engl J Med 1993; 329: 12631265.Google Scholar
Donabedian A. Evaluating the quality of medical care. Milbank Mem Fund Q 1966; 44 (Suppl): 166206.Google Scholar
Glisson C, James L. The cross-level effects of culture and climate in human service teams. J Organiz Behav 2002; 23: 767794.Google Scholar
Sugrue M, Seger M, Kerridge R, Sloane D, Deane S. A prospective study of the performance of the trauma team leader. J Trauma 1995; 38: 7982.Google Scholar
Williams M. Improved trauma management with ATLS training. J Accid Emerg Med 1997; 14: 8183.Google Scholar
Hoff W, Reilly P, Rotondo M, DiGiacomo J, Schwab C. The importance of the command-physician in trauma resuscitation. J Trauma 1997; 43: 772777.Google Scholar
Wears R, Perry S. Human factors and ergonomics in the emergency department. Pract Emerg Med 2002; 40: 206212.Google Scholar
Brooks A, Williams J, William B, Ryan J. General surgeons and trauma. A questionnaire survey of general surgeons training in ATLS and involvement in the trauma team. Injury 2002; 34: 484486.Google Scholar
Gautam V, Heyworth J. A method to measure the value of formal training in trauma management: comparison between ATLS and induction courses. Injury 1995; 26: 253255.Google Scholar
Haas N. The trauma centre: now and in the future. J Bone Joint Surg 2002; 84-B: 627630.Google Scholar