Major trauma critical pathway: preliminary results from the monitoring system in the regional network and in a hub center in Rome metropolitan area

Eur Rev Med Pharmacol Sci. 2020 Jul;24(13):7230-7239. doi: 10.26355/eurrev_202007_21878.

Abstract

Objective: The aim of this study is to collect the two years' data regarding the Integrated Trauma Management System (SIAT) by capturing the activity of its three Hubs in the Italian Lazio Region and test the performance of one of the Hubs' (Fondazione Policlinico Universitario A. Gemelli - IRCCS, FPG -IRCCS) Major Trauma Clinical Pathway's (MTCP) monitoring system, introducing the preliminary results through volume, process and outcome indicators.

Materials and methods: A retrospective analysis on SIAT was conducted on years 2016 to 2018, by collecting outcome and timeliness indicators through the Lazio Informative System whereas the MTCP was monitored through set of indicators from the FPG - IRCCS Informative System belonging to randomly selected clinical records of the established period.

Results: Hubs managed 11.3% of the 998,240 patients admitted in SIAT. All patients eligible for MTCP were "Flagged", and 83% underwent a CT within 2 hours; intra-hospital mortality was 13% whereas readmission rates 16.9%.

Conclusions: SIAT converges the most severe patients to its Hubs. The MTCP monitoring system was able to measure a total of 9 out of 13 indicators from the original panel. This research may serve as a departing point to conduct a pre-post analysis on the performance of the MTCP.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Critical Pathways / organization & administration*
  • Delivery of Health Care, Integrated / organization & administration*
  • Female
  • Hospital Mortality
  • Hospital Planning / organization & administration*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care / organization & administration*
  • Patient Readmission
  • Quality Indicators, Health Care / organization & administration
  • Retrospective Studies
  • Rome
  • Time Factors
  • Time-to-Treatment / organization & administration
  • Trauma Centers / organization & administration*
  • Treatment Outcome
  • Triage / organization & administration
  • Wounds and Injuries / diagnosis
  • Wounds and Injuries / mortality
  • Wounds and Injuries / therapy*
  • Young Adult