Feasibility and Acceptance of a Teletrauma Surgery Consult Service to Rural and Community Hospitals: A Pilot Study

被引：11

作者：

Kamine, Tovy Haber ^{[1
,2
,5
]}

Siu, Margaret ^{[2
]}

Kramer, Kristina Z. ^{[1
,2
]}

Alouidor, Reginald ^{[1
,2
]}

Kelly, Edward ^{[1
,2
]}

Deutsch, Ashley ^{[3
]}

Mader, Timothy J. ^{[3
,5
]}

Visintainer, Paul ^{[4
,5
]}

Grochowski, Kristina ^{[1
,2
]}

Jabbour, Nicolas ^{[2
]}

机构：

[1] Univ Massachusetts, Chan Med Sch, Baystate Med Ctr, Div Trauma Acute Care Surg & Surg Crit Care, Springfield, MA USA

[2] Univ Massachusetts, Baystate Med Ctr, Dept Surg, Chan Med Sch, Springfield, MA USA

[3] Univ Massachusetts, Baystate Med Ctr, Dept Emergency Med, Chan Med Sch, Springfield, MA USA

[4] Univ Massachusetts, Baystate Med Ctr, Dept Med, Chan Med Sch, Springfield, MA USA

[5] Univ Massachusetts, Chan Med Sch, Dept Healthcare Policy & Populat Sci, Springfield, MA USA

来源：

JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS | 2023年 / 236卷 / 01期

关键词：

TRAUMA PATIENTS; AMERICAN-COLLEGE; TELEMEDICINE; CARE; EMERGENCY; TRANSFERS; GUIDELINES; OUTCOMES; TRIAGE; IMPACT;

D O I：

10.1097/XCS.0000000000000460

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

BACKGROUND: Many trauma patients currently transferred from rural and community hospitals (RCH) to Level I trauma centers (LITC) for trauma surgery evaluation may instead be appropriate for immediate discharge or admission to the local facility after evaluation by a trauma and acute care surgery (TACS) surgeon. Unnecessary use of resources occurs with current practice. We aimed to demonstrate the feasibility and acceptance of a teletrauma surgery consultation service between LITC and RCH. STUDY DESIGN: LITC TACS surgeons provided telehealth consults on trauma patients from 3 local RCHs. After consultation, appropriate patients were transferred to LITC; selected patients remained at or were discharged from RCH. Participating TACS surgeons and RCH physicians were surveyed. RESULTS: A total of 28 patients met inclusion criteria during the 5-month pilot phase, with 7 excluded due to workflow issues. The mean +/- SD age was 63 +/- 17 years. Of 21 patients, 7 had intracranial hemorrhage; 12 had rib fractures. The mean +/- SD Injury Severity Score was 8.1 +/- 4.0). A total of 6 patients were discharged from RCH, 4 admitted to RCH hospitalist service, 2 transferred to a LITC emergency room, and 9 transferred to LITC as direct admission. There was one 30-day readmission and no missed injuries or complications, or deaths. RCH providers were highly satisfied with the teletrauma surgery consultation service, TACS surgeons, and equipment used. Mental demand and effort of consulting TACS surgeons decreased significantly as the consult number increased. CONCLUSIONS: Teletrauma surgery consultation involving 3 RCH within our system is feasible and acceptable. A total of 10 transfers and 19 emergency department visits were avoided. There was favorable acceptance by RCH providers and TACS surgeons. (J Am Coll Surg 2023;236:145-153. (c) 2022 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)

引用

页码：145 / 153

页数：9

共 33 条

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