Back to accessibility links

Trauma Team Redesign

Westmead Hospital
Project Added:
5 August 2013
Last updated:
17 October 2014

Trauma Team Redesign

By Carla Edwards, Margaret Murphy and Julie Seggie, Western Sydney Local Health District

Aim

A multidisciplinary team, consisting of doctors, nurses, clerical, ambulance and allied health staff from Westmead Emergency Department (ED) and Trauma Services came together to discuss opportunities to improve the trauma patient journey within the Emergency Department.

The initiative aimed to identify factors that contributed to problems and to focus on processes that would contribute to the smooth delivery of patient centred quality care in the resuscitation environment.

This initiative was born from growing disharmony between professions and services involved in the resuscitation and treatment of trauma patients. Anecdotal perceptions of trauma management included complaints of overcrowding in the trauma area, ineffective communication due to noise levels and disjointed teamwork.

Four clinicians training on a dummy

Method

Information collected through the process mapping, staff, patient and family interviews was consolidated and five predominant themes were prioritised in a solution design workshop, where the trauma team structure and framework were redesigned.

The process delineated many features of the trauma team which were either redundant, non value adding or affecting the cohesion and function of the trauma team. Recurrent issues relating to trauma team interaction, effectiveness and synergy and the impact of these issues on patient safety, experience and outcomes were identified. The highest priority area for solution development was the trauma team structure and team work.

To address the issues related to trauma team structure and team work the roles of the team were reviewed, redesigned and clinical goals established and clarified for each team member. The roles of the team became goal focused rather than task directed and there was now a multi-disciplinary orientation to the trauma team.

A contextualised simulated multi-specialty trauma team training course was developed to implement and test the structure. The simulation training course specifically addressed the structure of the team as well as the coordination of processes required to deliver trauma management. Photographs of the Westmead resuscitation bay were used to reconfigure the simulation centre to act as a realistic environmental representation. The simulation scenarios were adopted to address the findings of the project such as trauma team leadership, role delineation within the team, communication and role of debriefing.

Results

As a result of the training, improvements in trauma team performance have been realised. The team is now "high performing", with a focus on quality. There is evidence of sustainable change in practice despite the many challenges faced by the ED. Solution development and planning for sustainable change has led to innovation in trauma team training with Westmead Hospital being the first to engage in interdisciplinary trauma team training. This team training course continues to evolve as changes occur within the local and broader health system.

Participant evaluation of the course strongly agreed that interdisciplinary team training was useful. This training course is a sort after commodity by all areas and this also provides an opportunity for facilitator mentorship.

Audits show that the times it takes to critical events such as CT, angiography, thoracotomy and laparotomy have improved since the introduction of trauma team training.

Various services involved in trauma management now interact and communicate better as a result of the redesign and the team training development. Staff involvement and engagement, detailed diagnostics, collaboration between multi-professional stakeholders and ED executive leadership have been pivotal to the success of the project. 

More Information

  • Trauma Team Redesign (PDF File pdf - 559 KB)
  • Edwards, C, Seggie, J, Murphy, M. Redesigning the response to patients with trauma, Emergency Nurse, vol.20, no.2, May 2012, 31-36.
  • Murphy, M, Edwards, C, Seggie, J, Curtis, K. Emergency Department Trauma Redesign in a Level 1 Trauma Centre, Australasian Emergency Nursing Journal (2011) vol 14, no.1, 50-58.

Contacts


Program Coordinator
Department of Innovation and Redesign
Executive Medical Services
Western Sydney Local Health District
Phone: 02 9840 4016


Clinical Nurse Consultant
Emergency Department, Westmead Hospital
Western Sydney Local Health District
Phone: 02 9845 7585


Trauma Program Manager
Trauma Unit, Westmead Hospital
Western Sydney Local Health District
Phone: 02 9845 7058

Search Projects

Browse Projects

Submit your local innovation
and improvement project