Kappel David A, Rossi Daniel C, Polack Edward P, Avtgis Theodore A, Martin Matthew M
Department of Surgery, West Virginia University, Morgantown, West Virginia, USA.
J Trauma. 2011 Feb;70(2):315-9. doi: 10.1097/TA.0b013e318209589e.
The Rural Trauma Team Development Course (RTTDC) was developed by the ad hoc Rural Trauma Committee of the American College of Surgeons, Committee on Trauma to address the increased mortality of the rural trauma patient. The effectiveness of the RTTDC in shortening the interval from patient arrival to decision to transfer and the effect on the transfer process of communication training emphasizing team building is the focus of this study.
Rural level III and level IV trauma centers (N=18) were enrolled in a multiinstitutional 3-month longitudinal study of transferred trauma patients. Results were compared with institutions having hosted RTTDC versus those institutions not yet exposed to the course.
One-way analysis of variance was conducted. Results indicated that RTTDC training alone and RTTDC including communication training resulted in a statistically significantly shorter (p<0.05) time for decision to transfer. Transferring squad arrival time was also significantly reduced (p<0.01) as was the number of transferring squads contacted (p<0.01). No differences were observed among the trauma facilities and the number of receiving facilities contacted, (p=0.64) or in the time required to find an accepting facility (p=0.72).
The RTTDC alone and with the embedded communication module significantly reduce delays in the transfer process of the rural trauma patient.
农村创伤团队发展课程(RTTDC)由美国外科医师学会创伤委员会特设的农村创伤委员会开发,旨在解决农村创伤患者死亡率上升的问题。本研究的重点是RTTDC在缩短从患者到达至决定转院的时间间隔方面的有效性,以及强调团队建设的沟通培训对转院过程的影响。
农村三级和四级创伤中心(N = 18)参与了一项针对转院创伤患者的多机构为期3个月的纵向研究。将结果与接受过RTTDC培训的机构和尚未接触该课程的机构进行比较。
进行了单因素方差分析。结果表明,仅RTTDC培训和包括沟通培训的RTTDC培训导致决定转院的时间在统计学上显著缩短(p < 0.05)。转院小组到达时间也显著减少(p < 0.01),联系的转院小组数量也显著减少(p < 0.01)。在创伤设施和联系的接收设施数量之间未观察到差异(p = 0.64),或者在找到接收设施所需的时间方面也未观察到差异(p = 0.72)。
单独的RTTDC以及包含沟通模块的RTTDC可显著减少农村创伤患者转院过程中的延误。