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Improving the availability of intra-operative images created during trauma operations - a multidisciplinary team collaboration.

ABSTRACT: Intraoperative x rays are regularly taken on multiple occasions during orthopaedic surgery, especially during the course of planned trauma lists where procedures are performed under x ray guidance. These images have an important role in demonstrating the nature of the operation to clinical staff and in permitting an assessment of the standard of surgery by colleagues at planned metalwork reviews. Furthermore, they represent an important medico-legal record of the fracture configuration at the time of completion of surgery. Various technologies are available for the creation, storage, and presentation of such images. In our hospital, relatively unsophisticated technology is employed to physically print such x rays before they are digitally uploaded to an electronic computer system to be stored. This system also allows the images to be viewed. Unfortunately, many opportunities existed within our systems which created opportunities for images to be lost so that they were not made available to clinical staff. We aimed to evaluate and improve this system with the aim of making all x rays taken intraoperatively available to clinical staff in a timely manner. By examining the processes through which images were handled, we were able to adopt strategies to ensure the prompt production of images.

SUBMITTER: Hayes T

PROVIDER: S-EPMC4693042 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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Project description:PurposeTrauma team activation (TTA) is thought to be essential for advanced and specialized care of very severely injured patients. However, non-specific TTA criteria may result in overtriage that consumes valuable resources or endanger patients in need of TTA secondary to undertriage. Consequently, criterion standard definitions to calculate the accuracy of the various TTA protocols are required for research and quality assurance purposes. Recently, several groups suggested a list of conditions when a trauma team is considered to be essential in the initial care in the emergency room. The objective of the survey was to post hoc identify trauma-related conditions that are thought to require a specialized trauma team that may be widely accepted, independent from the country's income level.MethodsA set of questions was developed, centered around the level of agreement with the proposed post hoc criteria to define adequate trauma team activation. The participants gave feedback before they answered the survey to improve the quality of the questions. The finalized survey was conducted using an online tool and a word form. The income per capita of a country was rated according to the World Bank Country and Lending groups.ResultsThe return rate was 76% with a total of 37 countries participating. The agreement with the proposed criteria to define post hoc correct requirements for trauma team activation was more than 75% for 12 of the 20 criteria. The rate of disagreement was low and varied between zero and 13%. The level of agreement was independent from the country's level of income.ConclusionsThe agreement on criteria to post hoc define correct requirements for trauma team activation appears high and it may be concluded that the proposed criteria could be useful for most countries, independent from their level of income. Nevertheless, more discussions on an international level appear to be warranted to achieve a full consensus to define a universal set of criteria that will allow for quality assessment of over- and undertriage of trauma team activation as well as for the validation of field triage criteria for the most severely injured patients worldwide.

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Improving the availability of intra-operative images created during trauma operations - a multidisciplinary team collaboration.

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