ABSTRACT
Modern concepts of patient-centered care emphasize effective communication with patients and families, an essential requirement in acute trauma settings. We hypothesized that using a checklist to guide the initial family conversation would improve the family's perception of the interaction. Institutional Review Board-approved, prospective pre/post study involving families of trauma patients admitted to our Level I trauma center for >24 hours. In the control group, families received information according to existing practices. In the study group, residents gave patient information to a first-degree family member using a checklist that guided the interaction. The checklist included a physician introduction, patient condition, list of known injuries, admission unit or intensive care unit, any consultants involved, plans for additional studies or operations, and opportunity for family to ask questions. An 11-item survey was administered 24 to 48 hours after admission to each group that evaluated the trauma team's communication in the areas of physician introduction, patient condition, ongoing treatment, and family perception of the interaction. Responses were on a Likert scale and analyzed using the Wilcoxon-Mann-Whitney test. There were 130 patients in each group. The study group had significantly (P < 0.05) better responses in 8 of 11 items surveyed: physician spoke to family, physician introduction, understanding of their relative's injuries, admitting unit, consultants involved, urgent surgical procedures required, ongoing diagnostic studies, and understanding of the treatment plan. In conclusion, using a checklist improves the perception of the initial communication between the trauma team and family members of trauma patients, especially their understanding of the treatment plan.
Subject(s)
Checklist , Communication , Patient Care Team/organization & administration , Quality Improvement , Trauma Centers/organization & administration , Wounds and Injuries/therapy , Adolescent , Adult , Cohort Studies , Female , Hospital Mortality , Humans , Injury Severity Score , Male , Middle Aged , Professional-Family Relations , Prospective Studies , Statistics, Nonparametric , Treatment Outcome , West Virginia , Wounds and Injuries/diagnosis , Wounds and Injuries/mortality , Young AdultABSTRACT
"Venous thromboembolism (VTE) remains a significant risk for all surgical patients, despite validated guidelines. Development of VTE remains a high risk in hospitalized surgical patients, leading to complications in up to 30%. The stratification of patient risk factors and subsequent utilization of a validated prophylaxis and treatment regimen is, therefore, of utmost importance. Familiarity with the current guidelines and recommendations ultimately results in decreased morbidity, mortality, and health care costs. This article discusses the risk factors for developing VTE and management strategies based on the currently available guidelines."