Williams Tara, Nolan Brodie, McGowan Melissa, Johnston Tania, Maria Sonja, von Vopelius-Feldt Johannes
Ornge, Mississauga, ON, Canada.
Department of Emergency Medicine, St. Michael's Hospital Toronto, Unity Health Toronto, Toronto, ON, Canada.
Scand J Trauma Resusc Emerg Med. 2024 Dec 19;32(1):134. doi: 10.1186/s13049-024-01296-w.
Pre-alerts from paramedics to trauma centers are important for ensuring the highest quality of trauma care. Despite this, there is a paucity of data to support best practices in trauma pre-alert notifications. Within the trauma system of Ontario, Canada, the provincial critical care transport organization, Ornge, provides pre-alerts to major trauma centers, but standardization is currently lacking. This study examined the satisfaction of trauma team leaders' (TTLs) satisfaction with current trauma pre-alerts and their preferences for logistics, content, and structure.
This was a quantitative survey of TTLs at adult and pediatric trauma centers across Ontario, Canada. Recruitment was through email to trauma directors, with follow-up efforts to target low-response sites to achieve good geographical representation. The survey was completed online and contained a combination of single or multiple-choice questions, Likert scales and free text options.
In total, 79 TTLs from adult and pediatric lead trauma centers across Ontario responded to the survey, which took place over a 120-day period. The survey achieved good geographical representation. Given the current processes, TTLs describe moderate satisfaction with room for improvement (median score 3, IQR 3-4 on a 5-point Likert scale). Their overall preference was for timely and direct communication, with some concerns about multiple channels of communication around logistics. Most TTLs agreed on the important and less important content details found in common standardized framework tools. For structure, 28/79 TTLs strongly preferred the cognitive aid ATMIST, 13/79 preferred IMIST-AMBO, and 8/79 preferred MIST or SBAR as the most useful.
There is room for improvement through standardizing communication and streamlined pre-alert channels. Some disagreements exist between TTLs, particularly regarding logistics. Further research should examine TTL satisfaction after implementing the change in the pre-alert notification framework, which can address localized issues through stakeholder meetings with individual TTLs.
护理人员向创伤中心发出预通知对于确保最高质量的创伤护理非常重要。尽管如此，支持创伤预通知最佳实践的数据却很少。在加拿大安大略省的创伤系统中，省级重症监护运输组织Ornge会向主要创伤中心发出预通知，但目前缺乏标准化。本研究调查了创伤团队负责人（TTL）对当前创伤预通知的满意度以及他们对后勤、内容和结构的偏好。
这是一项对加拿大安大略省成人及儿科创伤中心的TTL进行的定量调查。通过电子邮件向创伤主任进行招募，并对回复率低的站点进行跟进，以实现良好的地域代表性。该调查通过在线完成，包含单项或多项选择题、李克特量表和自由文本选项。
在120天的时间里，安大略省成人及儿科主要创伤中心的79名TTL对调查做出了回应。该调查实现了良好的地域代表性。鉴于当前的流程，TTL表示满意度一般，仍有改进空间（在5分李克特量表上，中位数为3分，四分位距为3 - 4分）。他们总体上倾向于及时和直接的沟通，对围绕后勤的多种沟通渠道存在一些担忧。大多数TTL对常见标准化框架工具中重要和不太重要的内容细节达成了共识。对于结构，28/79的TTL强烈倾向于认知辅助工具ATMIST，13/79倾向于IMIST - AMBO，8/79倾向于MIST或SBAR为最有用的工具。
通过标准化沟通和简化预通知渠道仍有改进空间。TTL之间存在一些分歧，特别是在后勤方面。进一步的研究应在实施预通知框架变更后检查TTL的满意度，这可以通过与个别TTL举行利益相关者会议来解决局部问题。
