title: Reduction of time to definitive care in trauma patients: effectiveness of a new checklist system.
abstract: This study evaluated the feasibility of establishing a new trauma transfer checklist and assessed its impact on trauma-related interhospital transfers. A standard envelope with a printed checklist (N.E.W.S.) incorporating four key concepts in the care and transfer of trauma patients was used. A prospective comparison of consecutive interhospital trauma transfers to the major trauma service between July 1999-May 2000 (pre-N.E.W.S.) and August 2000-November 2000 (post-N.E.W.S.) was made. Changes in management satisfaction were assessed by a Likert scale (1=poor to 5=excellent). Pre-N.E.W.S., 88 trauma patients were transferred and 20 trauma transfers were recorded post-N.E.W.S. The time to definitive care pre-N.E.W.S. was 443+/-322 min, and 339+/-108 min (P=0.014) post-N.E.W.S. The time in the referring hospital was also reduced from 343+/-310 min pre-N.E.W.S. to 197+/-90 min post-N.E.W.S (P=0.0002). The checklist system prompted changes in the management of the trauma patient in 20% of the cases and there was a high level of satisfaction expressed by users of the checklist (4.6+/-0.7). The N.E.W.S. checklist is effective in facilitating the interhospital transfer of trauma patients by shortening the time to definitive care.
authors.affiliation: Director of Trauma Department, Liverpool Hospital, Elisabeth Street, NSW 2170, Liverpool, Australia. michael.sugrue@swsahs.nsw.gov.au
authors.forename: Patrick
authors.initials: P
authors.lastname: Schoettker
authors.forename: Scott K
authors.initials: SK
authors.lastname: D'Amours
authors.forename: Nadia
authors.initials: N
authors.lastname: Nocera
authors.forename: Erica
authors.initials: E
authors.lastname: Caldwell
authors.forename: Michael
authors.initials: M
authors.lastname: Sugrue
mesh_terms: D000328:Adult; D003625:Data Collection; D005240:Feasibility Studies; D006801:Humans; D008499:Medical Records; D009517:New South Wales; D010360:Patient Transfer / Q000458:organization & administration*; D011446:Prospective Studies; D013997:Time Factors; D014187:Transportation of Patients / Q000458:organization & administration; D015599:Trauma Severity Indices