Effect of team training on efficiency of trauma care in a Chinese hospital

Abstract

Objective: Multidisciplinary trauma teams are the standard of care in the USA, but staffing differences and lack of advanced trauma life support training hinder replication of this system in Chinese hospitals. We investigated the effect of simulation team training on initial trauma care. Methods: Over 15 months, we compared grade I trauma patients cared for by the trained team and those cared for using traditional practice on times from emergency room arrival to tests/ procedures. Propensity-score analysis was performed to improve between-group comparisons. Results: During the study, 144 grade I trauma patients were treated. Trained team patients showed shorter times from emergency room arrival to initiation of hemostasis (31.0 [13.5–58.5] vs. 113.5 [77–150.50] min), blood routine report (8 [5–10.25] vs. 13 [10–21] min), other blood tests (21 [14.75–25.75] vs. 31 [25–37] min), computed tomography scan (29.5 [20.25–65] vs. 58.5 [30.25–71.25] min) and tranexamic acid administration (31 [13–65] vs. 90 [65–200] min). Similar results were obtained for the propensity-score matched cohort. Conclusion: Simulation team training could help reduce time to blood routine reports, scans and hemostasis. Assessment of available resources and development of targeted team training could improve care in resource-limited hospitals.