Tag Archives: prevention

EAST 2019 #6: Trauma Prevention and Your Trauma Registry

Trauma centers verified by the American College of Surgeons (ACS) (and most states who perform their own designation visits) are required to engage in trauma prevention activities. Furthermore, ACS centers are required to provide prevention programs based on identified local needs. Frequently, trauma professionals see a pattern of injury in the patients they treat. This generally stimulates a search through their trauma registry. Reviewing registry data is the most direct way of identifying and confirming injury patters specific to the local population.

The next abstract for review describes the process and outcomes of such a project from a Level II center in Fort Walton Beach, Florida. They noted a pattern of diving injury and high cervical fractures. This was confirmed using 2016 registry data. Admitted patients were intensive resource users, with 71% requiring ICU admission and operative fixation, and nearly half requiring rehab admission upon discharge.

Based on this, they developed a “Think Before You Dive” program with posters, signs, swag (a custom koozie), a trifold brochure, and magnets with diving and water safety tips. Posters and flyers were provided to local business, and magnets were placed in hotel rooms in the area. One time-share company even placed a hard stop in their registration process so that visitors had to acknowledge the safety message.

What’s a koozie, you ask? I didn’t know the technical term for this, but here’s a picture:

Here are the factoids:

  • There was a reduction of 100% in cervical spine injuries, and 24% of all water-related incidents in the targeted area
  • All remaining diving/high-cord injuries came from outside the target area
  • It was estimated that costs were reduced by $1.2 million

As you can see, this is not the typical hard research paper usually provided at most scientific meetings. However, it is very important that this kind of information is presented, as it has the potential for impact on the other clinical research.

Here are some questions for the authors and presenter to consider in advance to help them prepare for audience questions:

  • How did you recognize the problem initially? Was it a pattern picked up by humans? Which ones (nurses, trauma physicians, therapists/rehab, others)?
  • Why did you think that your prevention approach would be effective?
  • Provide some details on how you convinced businesses to carry your message. Was there any resistance, and what were their arguments? How did you overcome it?
  • Show us the numbers. Although it may be difficult to show statistical differences in patient numbers, cost savings is important as well. Show the patient numbers pre- and post-intervention for the cluster area and outside of it.
  • Define how you arrived at your cost savings numbers. How do the previously published economic numbers relate to costs at your own center and those reported in this study?

I believe that this is important information, and will help many other centers properly design their own trauma prevention programs!

Reference: Using the trauma registry to guide your injury prevention programs. EAST 2019 Paper #18.

The  December Trauma MedEd Newsletter Is Available!

This month’s newsletter deals with a topic near and dear to all trauma programs: Prevention. Here are the topics covered:

  • Prevention and the ACS
  • The “Most Common” Causes of Trauma Deaths
  • Common Prevention Activities
  • Do Prevention Programs Work?
  • Tips For Trauma Center-Based Prevention Programs

Subscribers received this issue last week. Subscribe now and be sure to get the next issue early.  So sign up for early delivery now by clicking here!

Click here to download the current issue

Pick up back issues here!

newsletter201612

Next Trauma MedEd Newsletter Is Coming Next Week!

As promised, the next Trauma MedEd newsletter will be released next week. Just in time for some light Christmas reading!

The topic is “Prevention.” Here are the areas I’ll be covering:

  • The American College of Surgeons requires all US trauma centers to engage in prevention activities. Unfortunately, there is frequently confusion about the role of the injury prevention coordinator, what kinds of programs are acceptable, and how local data needs to be included in prevention planning. I will cover all of this, and more, in the first part of the newsletter.
  • Curious about what others are doing out there? I’ll give you an idea of the most common prevention programs, and whether they are national programs or home grown.
  • I’ll review a few papers on the efficacy of trauma prevention programs.
  • Finally, I’ll give some tips on how to optimize the performance of your injury prevention coordinator and design effective programs.

As always, this issue will go to all of my subscribers first. If you are not yet one of them, click this link to sign up and/or download back issues.

Unfortunately, non-subscribers will have to wait until I release the issue on this blog, sometime during the week after Christmas. So sign up now!

The Next Trauma MedEd Newsletter: All Things Prevention

All trauma centers in the US, and many in other parts of the world, are required to have injury prevention programs. Level I centers in the States are also required to have a named Injury Prevention Coordinator with a job description and salary support.

In this newsletter, I’m going to dig into the specifics of injury prevention. Some of the topics I will cover include:

  • Explaining the American College of Surgeons injury prevention requirements
  • A list of the most common types of injury prevention programs around the US
  • Efficacy of specific prevention programs (violence prevention, elderly falls)
  • Making your injury prevention coordinator great
  • Tips on designing an excellent trauma prevention program
  • And more!

This issue will be available sometime in mid-December. As usual, it will be emailed to all subscribers first. About two weeks later, I’ll make it available to all here on the blog.

If you want to get it as soon as it is released, please subscribe by clicking here! And you can pick up back issues when you follow the link, too!

A Cool Way To Look At Injury Data

Governmental agencies everywhere collect trauma related data. The US federal government maintains a number of databases, such as the Fatal Accident Reporting System (FARS), the Census of Fatal Occupational Injuries (CFOI) and many others. States collect similar but smaller datasets. Even towns and municipalities collate injury information in the form of prehospital run sheets.

But reams of data are of no use unless you can learn something from it. Unfortunately, most of this data is tucked away in database management systems, or in some cases just stacks of paper forms locked up somewhere. In order for humans to make sense of it and do useful things with it, we need to transform it into forms that we can easily interpret and make sense of. 

Fortunately, there are lots of visual, electronic tools available to help us do just that. One of the most helpful tools is the programmable geographic information system (GIS). An example of this is Google Maps. Most of us have used this or a similar tool in some form, usually to get directions from here to there. But you may not be aware that Google provides a programming interface so a savvy user can place any type of geography-related data on the map, creating what is called a mashup.

Imagine crossing the FARS database, which contains extensive data points on every fatal road accident in the US, with a mapping system. This would allow creation of a map showing where every person lost their life in a road accident, along with additional pertinent information about the event. A great example of this is demonstrated below. It was created by ITO World Ltd., based in the UK. They crossed fatality information with geographic map data in both the US and the UK.

image

This map shows fatal road events around Minneapolis from 2001 to 2009. The type of event (pedestrian struck, motor vehicle crash, etc.) is displayed along with age, year and sex. It is movable and zoomable so it can be viewed it in great detail. Click on the map above to open a new window to the full map.

Bottom line: Using trauma data / map mashups is a great way to visualize complex information. It also allows us to plan meaningful prevention activities based on local information (a requirement for ACS trauma center verification). Imagine looking over such a map of your city, and identifying a cluster of pedestrian fatalities. Then you notice that this cluster is 2 blocks away from an elementary school. This could prompt you to work with the school to implement automobile awareness programs for the children, have the city review signage and obstructions to view in the area, and optimize the number and placement of crossing guards. Then redo the map afterwards to judge the impact. Wow!

Website: http://map.itoworld.com/road-casualties-usa#fullscreen 

Reference: Using geographic information systems in injury research. J Nurs Scholarsh 39(4):306-311, 2007.