From the Center for Surgery and Public Health (S.I., C.E.C., N.P., C.L.Z., G.A.A., J.P.H.-E.), Division of Trauma, Burn, and Surgical Critical Care (S.I., N.P., A.S., G.A.A., J.P.H.-E.), Brigham and Women's Hospital, and Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation (S.G.G., J.C.S.), Harvard Medical School; Boston University School of Public Health (M.D.S., L.E.K.); Massachusetts General Hospital (C.M.R.); Shriners Hospital for Children (C.M.R.), Harvard Medical School, Boston, Massachusetts; and Department of Surgery (D.H.L.), Division of Trauma and Critical Care, Rutgers-New Jersey Medical School, Newark, New Jersey.
J Trauma Acute Care Surg. 2024 Oct 1;97(4):e41-e52. doi: 10.1097/TA.0000000000004384. Epub 2024 May 9.
Trauma centers demonstrate an impressive ability to save lives, as reflected by inpatient survival rates of more than 95% in the United States. Nevertheless, we fail to allocate sufficient effort and resources to ensure that survivors and their families receive the necessary care and support after leaving the trauma center. The objective of this scoping review is to systematically map the research on collaborative care models that have been put forward to improve trauma survivorship. Of 833 articles screened, we included 16 studies evaluating eight collaborative care programs, predominantly in the United States. The majority of the programs offered care coordination and averaged 9 months in duration. Three fourths of the programs incorporated a mental health provider within their primary team. Observed outcomes were diverse: some models showed increased engagement (e.g., Center for Trauma Survivorship, trauma quality-of-life follow-up clinic), while others presented mixed mental health outcomes and varied results on pain and health care utilization. The findings of this study indicate that collaborative interventions may be effective in mental health screening, posttraumatic stress disorder and depression management, effective referrals, and improving patient satisfaction with care. A consensus on core elements and cost-effectiveness of collaborative care models is necessary to set the standard for comprehensive care in posttrauma recovery.
创伤中心展现出令人印象深刻的拯救生命的能力，这在美国超过 95%的住院患者生存率中得到了体现。然而，我们未能投入足够的努力和资源，以确保幸存者及其家属在离开创伤中心后得到必要的护理和支持。本范围综述的目的是系统地描绘已提出的改善创伤后生存状况的协作护理模式的研究。在筛选出的 833 篇文章中，我们纳入了评估 8 个协作护理项目的 16 项研究，这些项目主要在美国开展。大多数项目提供护理协调，平均持续 9 个月。四分之三的项目在其主要团队中纳入了心理健康提供者。观察到的结果多种多样：一些模式显示出更高的参与度（例如，创伤幸存者中心、创伤生活质量随访诊所），而其他模式则表现出混合的心理健康结果，以及在疼痛和医疗保健利用方面的不同结果。本研究的结果表明，协作干预措施可能在心理健康筛查、创伤后应激障碍和抑郁管理、有效转介以及提高患者对护理的满意度方面有效。需要就协作护理模式的核心要素和成本效益达成共识，以为创伤后康复的全面护理设定标准。
