Everyone worries about patient satisfaction these days, and rightly so. There’s quality of care, and there’s satisfaction with it. The two are tough to separate. Many hospitals administer surveys and questionnaires after discharge about the overall hospital stay. But who looks at the experience of going through a trauma activation?
A very recent paper from Cornell and Penn interviewed trauma patients within 2 days of the trauma activation, and provided a $25 incentive to participate. There were 14 questions presented during a verbal interview, all open-ended. Patients with abnormal mental status during trauma activation were excluded, and data was collected over a 7 month period.
Here are the factoids:
- Most patients described fear and agitation, along with a loss of control
- 93% expressed concern about things other than themselves: family, work, safety
- Many patients remarked on the removal of their clothing. Some were concerned that they could not afford to replace them.
- Most participants noted that they received pain medicine early, but that it was not always effective immediately
- All participants described the team as caring and expert at what they do
- Patients appreciated the fact that team members introduced themselves and expressed concern for their wellbeing
- They were very observant of communication, and picked up on sidebar communications as well
Bottom line: Don’t underestimate what your patient observes and experiences during a trauma resuscitation. Unless head injured or intoxicated, they are picking up on everything you say and do. The trauma activation needs to be as patient-centered as possible while maintaining patient and team safety. Team members should be mindful of all communications, even when things are winding down. Try to spare patient clothing if possible. Use adequate analgesia and judicious sedation. And always remember to communicate clearly!
Reference: Patient experiences of trauma resuscitation. JAMA Surg 152(9):843-850, 2017.