title: Optimizing feedback from a designated level 1 trauma/burn center to referring hospitals.
abstract: BACKGROUND
  The American College of Surgeons Committee on Trauma (ACS-COT) is dedicated to improving the quality of care for severely injured patients. The ACS-COT charges designated centers with providing feedback to referring hospitals. There are no guidelines or recommendations as to what should be included in the feedback or how it should be used.
  
  
  METHODS
  The objectives of this study were to evaluate current feedback efforts regarding patients transferred to Harborview Medical Center (HMC), a regional level 1 trauma and burn center, to better understand how the feedback is used, and to evaluate what types of feedback are most useful to the referring hospitals. An analysis of U-link (password-protected access to patient's electronic medical record) and other forms of feedback was performed. A survey was sent to 82 Washington State hospitals in the regionalized trauma system to evaluate the current feedback process and its utility.
  
  
  RESULTS
  During 1 year, HMC admitted 5,988 trauma and 763 burn patients; 54.8% of trauma and 66.5% of burn admissions were transferred from referring hospitals. Currently, 90 different referring hospitals have acquired a U-link account to follow their patients. Discharge summaries were the primary source of information used. When hospitals were asked how this information is used, education (100%), systems analysis (98.5%), and quality assurance (92%) were most common.
  
  
  CONCLUSIONS
  There is significant interest on the part of referring hospitals to receive feedback from a designated level 1 trauma/burn center to improve quality of care. A system like U-link can allow secure access to review patient charts for quality improvement and feedback purposes, in a manner that is efficient for the referring and receiving hospitals.
authors.affiliation: Department of Surgery, Vanderbilt University, Nashville, TN. Electronic address: Lisa.Rae@vanderbilt.edu.
authors.forename: Lisa
authors.initials: L
authors.lastname: Rae
authors.affiliation: Department of Surgery, University of Washington, Harborview Medical Center, Seattle, WA.
authors.forename: Eileen
authors.initials: E
authors.lastname: Bulger
mesh_terms: D002053:Burn Units / Q000458:organization & administration*; D030141:Feedback, Psychological; D019538:Health Care Surveys; D006801:Humans; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D058996:Quality Improvement; D012017:Referral and Consultation / Q000458:organization & administration*; D014193:Trauma Centers / Q000458:organization & administration*; D014861:Washington