The impact of trauma case management on patient outcomes.
BACKGROUND
Previous investigations demonstrate that nursing case management in the acute care setting improves patient outcomes. However, these findings provide limited information specific to trauma patients.


METHODS
The effect of trauma case management (TCM) was measured using practice-specific variables such as in-hospital complications, missed injury rates, and length of stay. Other measures included staff satisfaction and use of allied health services. Data from 148 patients with an Injury Severity Score < 16 in the 5 months after the introduction of TCM were compared with 327 patients from the previous 12 months.


RESULTS
Results demonstrated a trend toward reduced length of stay overall, more so in the older and more severely injured. TCM greatly improved missed injury detection rates (p < 0.0015) and coordinated allied health use more efficiently (p < 0.0001). Staff surveys exhibited a perceived dramatic improvement in the effectiveness of patient care (p < 0.0001).


CONCLUSIONS
The introduction of TCM improved the efficiency and effectiveness of trauma patient care in our institution.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000720:Ancillary Services, Hospital / Q000706:statistics & numerical data; D019090:Case Management / Q000706:statistics & numerical data*; D003142:Communication; D003299:Cooperative Behavior; D003422:Critical Care / Q000379:methods; D005260:Female; D006784:Hospitals, Teaching / Q000458:organization & administration; D006786:Hospitals, Urban / Q000458:organization & administration; D006801:Humans; D015601:Injury Severity Score; D007588:Job Satisfaction; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D009738:Nursing Service, Hospital / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000453:epidemiology / Q000451:nursing* / Q000473:pathology