The Trauma Continuum-of-Care Quality Forum Integration Committee System-Wide Video Teleconference

Abstract

The lessons learned in the care of combat casualties throughout time have been vitally important to the improvement of military medicine. However, often the lessons learned were essentially personal, because the ability to transmit those lessons to other medical personnel was not systematized and organized. In past wars, the transmission of those lessons to other care providers was difficult and often long after the fact. Consultant visits were made and War Medicine conferences were held, but policy changes and actual changes in the mechanisms to provide care often lagged. Lessons learned often were not widely spread until years later. New capabilities in medical communications have permitted the development of real-time casualty care information exchange and rapid policy decision-making. This article describes one such effort.

Joint Theater Trauma System Implementation of Burn Resuscitation Guidelines Improves Outcomes in Severely Burned Military Casualties

“…Data would be used to evaluate outcomes, need for training, improve continuity of care, and facilitate system-wide data driven real-time changes. 4 Somewhat fortuitously, in September 2005 a weekly videoteleconference was organized via the JTTS to allow providers throughout all echelons of care a means to communicate and provide real-time feedback discussing care and transport from point of injury to the most appropriate level of care of the critically ill. 5 This provided an additional venue to instantly disseminate important clinical pathways or guidelines. It was through this newly established communications vehicle that we were able to rapidly disseminate the information that we had identified a systems problem and intervened with the new BRG and BFS.…”

Critical care at Landstuhl Regional Medical Center

“…A separate monthly video teleconference involves a larger and more diverse audience to discuss system-wide policy issues ranging from medic care at the point of wounding to rehabilitation in the Veteran's Administration network. Since 2005, these LRMC-initiated conferences have facilitated timely feedback and process improvement efforts for a trauma care system that spans 12 time zones (5).…”

Military contributions to modern trauma care

“…Prior to the Napoleonic wars, until the battle was finished wounded soldiers were generally left where they fell. The modern weekly teleconferences linking prehospital and hospital personnel in Afghanistan with staging and definitive care hospitals in the United States and United Kingdom, in which individual patients are discussed [11,12], are excellent templates for civilian trauma systems. The Crimean and American Civil Wars saw the introduction of professional nursing, turning nurses from doctors' assistants into independent clinicians and patient advocates.…”