Flow Disruptions in Trauma Surgery: Type, Impact, and Affect

Abstract

The objective of this study was to identify and understand all components of the trauma care process to mitigate the systemic challenges faced by clinicians attempting to deliver the best trauma care. The study was conducted using a prospective data collection method. An interdisciplinary team of researchers observed 87 cases over a 10-week period and identified 1759 flow disruptions. There were a higher number of flow disruptions per case in the operating room (M=61.3, ±36.72) than in the emergency department (M=9.2, ±1.77) or radiology (M=7.5, ±2.01). Focusing on the OR, the majority of the flow disruptions identified in the OR were due to either coordination issues (28%) or communication breakdowns (24%). Roughly 12% of disruptions resulted in moderate delays or full case cessation. This study demonstrates the value of using flow disruptions as a surrogate for efficiency and quality outcome measures, and as a diagnostic method for understanding higher order problems in the system of trauma care.