TY - JOUR
T1 - A consensus-based criterion standard for trauma center need
AU - Lerner, E. Brooke
AU - Willenbring, Brian D.
AU - Pirrallo, Ronald G.
AU - Brasel, Karen J.
AU - Cady, Charles E.
AU - Colella, M. Riccardo
AU - Cooper, Arthur
AU - Cushman, Jeremy T.
AU - Gourlay, David M.
AU - Jurkovich, Gregory J.
AU - Newgard, Craig D.
AU - Salomone, Jeffrey P.
AU - Sasser, Scott M.
AU - Shah, Manish N.
AU - Swor, Robert A.
AU - Wang, Stewart C.
PY - 2014/4
Y1 - 2014/4
N2 - Background: In civilian trauma care, field triage is the process applied by prehospital care providers to identify patients who are likely to have severe injuries and immediately need the resources of a trauma center. Studies of the efficacy of field triage have used various measures to define trauma center need because no "criterion standard" exists, making cross-study comparisons difficult. This study aimed to develop a consensus-based functional criterion standard definition of trauma center need. Methods: Local and national experts were recruited for participation. Blinded key informant interviews were conducted in order of availability until no new themes emerged. Themes identified during the interviews were used to develop a Modified Delphi survey, which was electronically delivered via Survey Monkey. The trauma center need criteria were refined iteratively based on participant responses. Participants completed additional surveys until there was at least 80% agreement for each criterion. Results: Fourteen experts were recruited. Five participated in key informant interviews. A Modified Delphi survey was administered five times (four modifications based on the expert's responses). After the fifth round, there was at least 82% agreement on each criterion. The final definition included 10 time-specific indicators: major surgery, advanced airway, blood products, admission for spinal cord injury, thoracotomy, pericardiocentesis, cesarean delivery, intracranial pressure monitoring, interventional radiology, and in-hospital death. Conclusion: We developed a consensus-based functional criterion standard definition of needing the resources of a trauma center, which may help to standardize field triage research and quality assurance in trauma systems as well as allow for cross study comparisons.
AB - Background: In civilian trauma care, field triage is the process applied by prehospital care providers to identify patients who are likely to have severe injuries and immediately need the resources of a trauma center. Studies of the efficacy of field triage have used various measures to define trauma center need because no "criterion standard" exists, making cross-study comparisons difficult. This study aimed to develop a consensus-based functional criterion standard definition of trauma center need. Methods: Local and national experts were recruited for participation. Blinded key informant interviews were conducted in order of availability until no new themes emerged. Themes identified during the interviews were used to develop a Modified Delphi survey, which was electronically delivered via Survey Monkey. The trauma center need criteria were refined iteratively based on participant responses. Participants completed additional surveys until there was at least 80% agreement for each criterion. Results: Fourteen experts were recruited. Five participated in key informant interviews. A Modified Delphi survey was administered five times (four modifications based on the expert's responses). After the fifth round, there was at least 82% agreement on each criterion. The final definition included 10 time-specific indicators: major surgery, advanced airway, blood products, admission for spinal cord injury, thoracotomy, pericardiocentesis, cesarean delivery, intracranial pressure monitoring, interventional radiology, and in-hospital death. Conclusion: We developed a consensus-based functional criterion standard definition of needing the resources of a trauma center, which may help to standardize field triage research and quality assurance in trauma systems as well as allow for cross study comparisons.
KW - Delphi method
KW - Wounds and injury
KW - emergency medical services
KW - emergency medical technicians
KW - trauma centers
KW - triage
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U2 - 10.1097/TA.0000000000000189
DO - 10.1097/TA.0000000000000189
M3 - Article
C2 - 24662885
AN - SCOPUS:84897045324
SN - 2163-0755
VL - 76
SP - 1157
EP - 1163
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
IS - 4
ER -