#Pa trauma center levels how to#
#Pa trauma center levels free#

> Was urine output less than 0.5 cc/kg/hour? > Were any risk factors present - contrast, CRI, shock, drugs (vancomycin/Zosyn)? Initiation of renal replacement therapy OR, in patients 1.5 (or baseline GFR What was the patient’s pre-admit/baseline creatinine? Increase in serum creatinine to ≥ 4.0mg/dl (≥353.6μmol/l) In general, what do minimal harm, moderate harm and severe harm look like for patients with this complication?įollowing is an example of an event review template for acute kidney injury (AKI), a common complication among trauma patients: NTDS Definition Is this an event that must go to secondary review, or can it be closed in primary review?Ĭlear parameters for determining patient harm. The level of review at which the event can be resolved. What does the trauma medical director (TMD) need to know about this patient and the care they received in order to make a determination? The clinical information necessary to review care. The definition should mirror the National Trauma Data Standard (NTDS) Data Dictionary and align with your center’s own performance improvement and patient safety (PIPS) process and clinical practice guidelines. There are four elements:Ī clear definition of the complication or event. The basic idea is to identify the key information needed to resolve your trauma program’s most common complications, PI audit filters and events.

#Pa trauma center levels how to#

How to create and use trauma PI event review templates Event review templates can also be a great tool for orienting new trauma program staff who may not have the luxury of receiving a proper hand-off from their predecessor.

#Pa trauma center levels free#

In the process, they free up time for corrective action planning and loop closure. Instead, we should follow a roadmap designed for evaluating common PI events - an event review template that assists in drilling down on events with consistencyĮvent review templates allow trauma program leaders to close more events at primary and secondary review, and they make secondary review meetings more efficient. In other words, when a PI event comes to our attention, we should not immediately start combing the chart for shortfalls and protocol variances. My suggestion - although it may be counterintuitive for us in trauma - is that trauma PI should be less like trauma surgery and more like general surgery. The idea is to go as rapidly as possible to the OR for a trauma laparotomy with a large midline incision. When a trauma surgeon has to control internal bleeding in a hypotensive patient who is too unstable to go to CT, step one is to do a quick FAST exam.The idea is to create a roadmap that shows exactly where to go and what to do. When a general surgeon has to resect a tumor, step one is to obtain extensive imaging studies.But to get an overall understanding, consider this analogy: I will explain this idea in detail below. In my experience, the solution is to develop event templates that focus the review process and facilitate decision-making. At times, it feels like the process creates additional work without providing additional benefit. In many trauma programs, however, managing events through the levels of review is a complicated process that absorbs time and attention. The “levels of review” model was created to make trauma performance improvement (PI) more efficient.