Trauma performance improvement (PI) is part art and part science. I tend to segregate the process into 3 segments: inputs, processing, and outputs. There are lots of possible inputs, including violation of specific audit filters (too long to OR, open fracture delay, etc.), referrals from M&M discussions, incident reports and video reviews of trauma resuscitations, to name a few.
There is one PI input that has the potential to be a problem, though: word of mouth. You know, someone tells the trauma program manager that things just didn’t go well during that last trauma resuscitation. This is a perfectly legitimate way to identify PI issues. However, “word of mouth” can be categorized by source into “identified” and “anonymous."
Word of mouth sources that are identified are not a problem. Anonymous ones are. All too often, these unsigned notes or suggestion box drops or phone messages are initiated by someone with an axe to grind. Most of the time, there is no basis for the incident that has been reported. The PI program can spend lots of time and energy trying to track down these perceived "problems”, and nothing ever comes of it.
There are two major problems with unsourced word of mouth “tips”:
- There is no way to get additional information about the event from the source
- It is not possible to thank the source for the information and let them know what was done to correct the issue
Bottom line: Performance improvement “tips” from anonymous sources are usually unfounded and a waste of time to investigate. Let it be known that your PI program is happy to receive written or verbal notices of potential problems that need to be pursued. However, every request must have a name and contact number and/or email included or it will be discarded.