The benefits of the trauma team leader (TTL), a specially designated team leader in the emergency department (ED), remained unclear. For a study, researchers sought to determine how the TTL would affect mortality after 72 hours. Other goals were admission delays from the ED and 24-hour mortality.
From 2003 to 2017, major trauma admissions (Injury Severity Score (ISS)≥12) at three Canadian Level-1 trauma centers were included. In 2005, center 1 began implementing the TTL program. The analysis used an interrupted time series (ITS). The analysis explains the shift in patient case mix (age, sex, and ISS). Sensitivity studies were performed using the two additional centers as a control.
Among the 20,193 trauma admissions that were documented, 14,479 (71.7%) were male. It was 53.5±22.0 years on average. The median [IQR] ISS was 22 and ranged from 16 to 26. About 72-hour and 24-hour mortality quarterly trends did not alter due to TTL deployment; adjusted estimates with 95% CI were 0.32 [-0.22;0.86] and -0.07 [-0.56;0.41] percentage-point changes, respectively. The percentage of patients hospitalized within 8 hours of ED presentation had similar findings (0.36 [-1.47;2.18]). Similar findings came from sensitivity studies that used the two additional centers as controls.
Implementing TTL was not linked to any changes in mortality or delays in ED admission. Future research should examine how TTL initiatives may affect other patient-centered outcomes utilizing various quality-of-care measures.
Reference: sciencedirect.com/science/article/pii/S0735675722006295
