Evidence map›Paper›PMID 39471084›Full record

ArticleAnnals of surgery2024

Failure Mode Effects Analysis of Re-triage of Injured Patients to Receiving High-Level Illinois Trauma Centers.

John D Slocum, Jane L Holl, William M Brigode, Mary Beth Voights, Michael J Anstadt, Marion C Henry, Justin Mis, Richard J Fantus, Timothy P Plackett, Eddie J Markul and 4 more

Abstract read
In one paragraph

Article in Annals of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

John D SlocumDepartment of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Jane L HollDepartment of Neurology, Pritzker School of Medicine, University of Chicago, Chicago, IL.
William M BrigodeDepartment of Trauma and Burn, John H. Stroger Hospital of Cook County, Chicago, IL.
Mary Beth VoightsDepartment of Surgery, Carle Foundation Hospital, Urbana, IL.
Michael J AnstadtDepartment of Surgery, Stritch School of Medicine, Loyola University, Chicago, IL.
Marion C HenryDepartment of Surgery, Comer Children's Hospital, Pritzker School of Medicine, University of Chicago, Chicago IL.
Justin MisDepartment of Trauma and Burn, John H. Stroger Hospital of Cook County, Chicago, IL.
Richard J FantusDepartment of Surgery, Advocate Illinois Masonic Medical Center, Chicago IL.
Timothy P PlackettDepartment of Surgery, Pritzker School of Medicine, University of Chicago, Chicago IL.
Eddie J MarkulDepartment of Emergency Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL.
Grace H ChangDepartment of Surgery, Mount Sinai Hospital, Chicago, IL.
Michael B ShapiroDepartment of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Nicole SiparskyDepartment of Surgery, Rush University Medical College, Chicago, IL.
Anne M SteyDepartment of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.ORCID 0000-0002-8334-0304

Funding

Timeliness of Management of Trauma Related Hemorrhage and Trauma Related CoagulopathyK23HL157832 · NHLBI · NORTHWESTERN UNIVERSITY AT CHICAGO · PI STEY, ANNE M · 2021 to 2025
$929k
NHLBI NIH HHS K23 HL157832
6 · The paper itself

Abstract

objectiveThis study identified failures in emergency inter-hospital transfer, or re-triage, at high-level trauma centers receiving severely injured patients. SUMMARY BACKGROUND DATA: The re-triage process averages four hours despite the fact timely re-triage within two hours mitigates injury-associated mortality. Non-trauma and low-level trauma centers reported most critical failures were in finding an accepting high-level trauma center. Critical failures at high-level trauma centers have not been assessed.

methodsThis was an observational cross-sectional study at nine high-level adult trauma centers and three high-level pediatric trauma centers. Failure Modes Effects Analysis (FMEA) of the re-triage process was conducted in four phases. Phase 1 purposively sampled trauma coordinators followed by snowball sampling of clinicians, operations, and leadership to ensure representative participation. Phase 2 mapped each re-triage step. Phase 3 identified failures at each step. Phase 4 scored each failure on impact, frequency, and safeguards for detection. Standardized rubrics were used in Phase 4 to rate each failure's impact (I), frequency (F), and safeguard for detection (S) to calculate their Risk Priority Number (RPN) (I x F x S). Failures were rank ordered for criticality.

resultsA total of 64 trauma coordinators, surgeons, emergency medicine physicians, nurses, operations and quality managers across twelve high-level trauma centers participated. There were 178failures identified at adult and pediatric high-level trauma centers. The most critical failures were: Insufficient trained transport staff (RPN=648); Issues transmitting imaging from sending to receiving centers (RPN=400); Incomplete exchange of clinical information(RPN=384).

conclusionsThe most critical failures were limited transportation and incomplete exchange of clinical, radiological and arrival timing information. Further investigation of these failures that includes several regions is needed to determine the reproducibility of these findings.

Identifiers

PMID39471084
PMCPMC12001997

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.