Utilizing a trauma systems approach to benchmark and improve combat casualty care

The Journal of Trauma
Brian J EastridgeS Ward Casscells

Abstract

Derived from the necessity to improve the outcomes of soldiers injured on the battlefield, the U.S. military forces developed and implemented the Joint Theater Trauma System (JTTS) and the Joint Theater Trauma Registry based on U.S. civilian trauma system models. The purpose of this analysis was to develop battlefield injury outcome benchmark metrics and to evaluate the impact of JTTS-driven performance improvement interventions. To quantify these achievements, the Joint Theater Trauma Registry captured mechanistic, physiologic, diagnostic, therapeutic, and outcome data on 18,377 injured patients from January 2004 to May 2008 for analysis. Benchmarks were developed and statistically validated by using control chart methodology. The majority (66.4%) of battlefield wounds were penetrating mechanism, 23.3% of all patients had an Injury Severity Score of > or = 16, 21.8% had a base deficit of > or = 5, 30.5% of patients required blood, and 6.8% required massive transfusion (> or = 10 units red blood cell per 24 hours). In this severely injured population from the battlefield, the JTTS developed several pertinent benchmark metrics to assess quality of care associated with postinjury complications and mortality. The implementation of...Continue Reading

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Citations

Jul 9, 2014·Diseases of the Colon and Rectum·Sean C GlasgowW Brian Perry
Nov 26, 2014·The Journal of Trauma and Acute Care Surgery·Matthew J EckertMatthew J Martin
Apr 24, 2013·The Journal of Trauma and Acute Care Surgery·Sasha D AdamsJohn B Holcomb
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Aug 4, 2011·The Journal of Trauma·Brian J EastridgeLorne H Blackbourne
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