The gold standard for trauma care involves a three-stage assessment – primary, secondary, and tertiary surveys – to ensure comprehensive evaluation of trauma patients. At a large urban trauma center, the tertiary survey was not part of the standard care process. Missed injuries as a result can lead to higher hospital costs and increased mortality. To address this issue, a trauma tertiary survey was developed and integrated into the electronic health record (HER) to minimize the occurrence of missed injuries.
Multiple systematic reviews and aggregate meta-analyses demonstrate that implementing a formal tertiary trauma survey (TTS) significantly increases detection of injuries missed during the initial assessment. Single-center implementation studies have shown absolute reductions in missed injury rates following TTS introduction. Missed injuries are associated with prolonged hospital stays, additional procedures, increased complications, and greater resource utilization. Consequently, reducing missed injuries through routine TTS represents a low-cost, high-value safety intervention that can meaningfully decrease hospital variable costs.
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