Information flow during pediatric trauma care transitions: things falling through the cracks

Peter Leonard Titus Hoonakker, Abigail Rayburn Wooldridge, Bat Zion Hose, Pascale Carayon, Ben Eithun, Thomas Berry Brazelton, Jonathan Emerson Kohler, Joshua Chud Ross, Deborah Ann Rusy, Shannon Mason Dean, Michelle Merwood Kelly, Ayse Pinar Gurses

Research output: Contribution to journalArticle

Abstract

Pediatric trauma is one of the leading causes of morbidity and mortality in children in the USA. Every year, nearly 10 million children are evaluated in emergency departments (EDs) for traumatic injuries, resulting in 250,000 hospital admissions and 10,000 deaths. Pediatric trauma care in hospitals is distributed across time and space, and particularly complex with involvement of large and fluid care teams. Several clinical teams (including emergency medicine, surgery, anesthesiology, and pediatric critical care) converge to help support trauma care in the ED; this co-location in the ED can help to support communication, coordination and cooperation of team members. The most severe trauma cases often need surgery in the operating room (OR) and are admitted to the pediatric intensive care unit (PICU). These care transitions in pediatric trauma can result in loss of information or transfer of incorrect information, which can negatively affect the care a child will receive. In this study, we interviewed 18 clinicians about communication and coordination during pediatric trauma care transitions between the ED, OR and PICU. After the interview was completed, we surveyed them about patient safety during these transitions. Results of our study show that, despite the fact that the many services and units involved in pediatric trauma cooperate well together during trauma cases, important patient care information is often lost when transitioning patients between units. To safely manage the transition of this fragile and complex population, we need to find ways to better manage the information flow during these transitions by, for instance, providing technological support to ensure shared mental models.

Original languageEnglish (US)
Pages (from-to)797-805
Number of pages9
JournalInternal and Emergency Medicine
Volume14
Issue number5
DOIs
StatePublished - Aug 1 2019

Keywords

  • Care transitions
  • Patient safety
  • Pediatric trauma
  • Teamwork

ASJC Scopus subject areas

  • Internal Medicine
  • Emergency Medicine

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  • Cite this

    Hoonakker, P. L. T., Wooldridge, A. R., Hose, B. Z., Carayon, P., Eithun, B., Brazelton, T. B., Kohler, J. E., Ross, J. C., Rusy, D. A., Dean, S. M., Kelly, M. M., & Gurses, A. P. (2019). Information flow during pediatric trauma care transitions: things falling through the cracks. Internal and Emergency Medicine, 14(5), 797-805. https://doi.org/10.1007/s11739-019-02110-7