Performance Improvement (PI) Monitoring

Population of Interest

1. All trauma patients who undergo surgery within 24 hours of arrival to first surgical role of care (includes all surgeries performed).
2. Patients who receive endotracheal tube/cricothyroidomy/tracheostomy before the initial surgery AND undergo surgical procedure at Role 2 or Role 3.

Intent (Expected Outcomes)

1. Anesthesia care is documented on an anesthetic record and uploaded to Theater Medical Data Story.
2. Trauma patients in the OR maintain a body temperature > 36˚C during surgery.
3. Anesthesia following major trauma will be induced and maintained with less than 20% drop in initial blood pressure.
4. Patients undergoing massive transfusion will receive blood products in 1:1:1:1 ratio (plasma:platelets:RBC: cryoprecipitate).
5. Calcium is administered to patients who have received: one unit and after every 4 units of red blood product transfused.
6. Antibiotics are administered to all patients prior to initiation of surgery incision.

Performance/Adherence Metrics

1. Number and percentage of patients in the population of interest who have anesthesia record received.
2. Number and percentage of trauma patients who maintained a body temperature > 36˚C during surgery (as recorded on anesthesia record).
3. Number and percentage of patients who do not drop systolic blood pressure more than 20 mmHg during the first 15 min after induction of anesthesia.
4. Number and percentage of patients undergoing massive transfusion (>10 u RBC + whole blood with 24 hours after injury) who received blood products in an FFP:RBC ratio between 0.5:1 to 1:1.5 while in the OR (as recorded on anesthesia record).
5. Number and percentage of patients undergoing massive transfusion (>10 u RBC + whole blood with 24 hours after injury) who receive platelet or whole blood transfusion while in the OR (as recorded on anesthesia record).
6. Number and percentage of patients who received more than 1 units of blood products transfused who also received calcium (as recorded on anesthesia record).
7. Number and percentage of patients who received antibiotic before surgery or documented no antibiotic indicated.

Data Source

- Patient Record
- Department of Defense Trauma