A Statewide Collaboration: Ohio Level III Trauma Centers' Approach to the Development of a Benchmarking System

Abstract

The American College of Surgeons Committee on Trauma revised the Resources for Optimal Care of the Injured Patient to include the criteria for trauma centers to participate in a risk-adjusted benchmarking system. Trauma Quality Improvement Program is currently the risk-adjusted benchmarking program sponsored by the American College of Surgeons, which will be required of all trauma centers to participate in early 2017. Prior to this, there were no risk-adjusted programs for Level III verified trauma centers. The Ohio Society of Trauma Nurse Leaders is a collaborative group made up of trauma program managers, coordinators, and other trauma leaders who meet 6 times a year. Within this group, a Level III Subcommittee was formed initially to provide a place for the Level III centers to discuss issues specific to the Level III centers. When the new requirement regarding risk-adjustment became official, the subcommittee agreed to begin reporting simple data points with the idea to risk adjust in the future.

An Educational Outreach Program: A Trauma System's 5-Year Experience

“…The former authors admitted that the success of their program was partially due to marketing (Byrnes et al, 2010), which is unsurprising considering that anecdotally, many outreach programs across the United States have been described as marketing schemes. Lang et al reported on a successful statewide outreach committee made up of trauma program managers, coordinators, and other program leaders, which came together and discussed benchmarking and PI of rural centers up to six times a year (Lang et al, 2016). The program's success described by Lang and colleagues was largely determined by the leadership and consistency of the committee, which created a good working relationship with trauma medical directors across rural centers to improve trauma care ultimately.…”

“…As a result, few studies have been published on trauma outreach programs, particularly in rural settings. Current outreach literature is primarily focused on performance improvement (PI) (Bradley et al, 2017; Byrnes et al, 2010; Lang et al, 2016), rural trauma development courses (Dennis et al, 2016; Gutenstein et al, 2019; Kappel et al, 2011), and other continuing medical education (Sidwell & Matar, 2017) designed to bolster education for rural trauma centers. Although all parts are necessary to run an outreach program, many previously mentioned studies are not current.…”

The impact of interhospital transfer on mortality benchmarking at Level III and IV trauma centers: A step toward shared mortality attribution in a statewide system

“…In a single state study in Ohio, one such study reported on the development of a benchmarking program for level III centers. This effort included structural measures (emergency department volume, rurality), process measures (average surgeon response time, % of orthopedic fractures managed operatively within 24 hours), and outcome measures (raw mortality) (11). Another single-state study from Colorado described the development of performance improvement filters relevant to level III and IV trauma centers, including such process measures as adherence to trauma team activation criteria, response time for trauma team leaders, and time to intubation for patients with Glasgow Coma Scores<9 (12).…”