The Rural Trauma Team Development Course (RTTDC) is yet another quality program developed by the American College of Surgeons (ACS). It is designed for all trauma professionals in rural areas including doctors, nurses, advanced practice providers, prehospital providers, and administrative support. The course is presented over the course of one day and covers a number of topics including:

• Organizing a rural trauma team
• Preparing rural hospitals to manage trauma patients
• Identifying local resources and limitations
• Resuscitation of trauma patients
• Initiating early transfer
• Developing a performance improvement process
• Building relationships between rural hospitals and regional or state trauma systems

The trauma group at Vanderbilt compared a group of six non-trauma hospital in rural Tennessee who had participated in the RTTDC with six other rural hospitals matched for size, volume, and distance from the Level I center.

Here are the factoids:

• A total of 130 RTTDC patients were compared with 123 from hospitals that had not participated
• Overall demographics and number of imaging studies were the same
• The call to transfer occurred 41 minutes sooner in the RTTDC hospitals
• Length of stay in the referring ED was 61 minutes shorter in the RTTDC hospitals
• Number of images obtained pre-transfer and mortality were unchanged

Bottom line: The numbers were small and the review was retrospective, but the results are nonetheless impressive. Granted, there was no decrease in mortality, but this is a relatively crude indicator, especially when small numbers are involved. But time to phone call and time spent in the referring ED were significantly shorter. Does anyone think that longer times to transfer are somehow good for patients?

Rural hospitals should consider attending RTTDC in order to improve the care of patients from their communities.

Reference: Rural trauma team development course de-creases time to transfer for trauma patients. J Trauma 81(4):632-637, 2016.