The Center for Trauma Survivorship: Addressing the great unmet need for posttrauma center care
| Autor: | Patricia A. Walling, Susan La Bagnara, Cherie Castellano, Peter Yonclas, Cathy Cho, Anne C. Mosenthal, David H. Livingston, Derrick Sieck |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Aftercare Poison control Survivorship Critical Care and Intensive Care Medicine Patient Readmission law.invention Stress Disorders Post-Traumatic Young Adult 03 medical and health sciences 0302 clinical medicine Trauma Centers law Survivorship curve Health care medicine Humans Depression (differential diagnoses) Aged Aged 80 and over Patient Care Team Health Services Needs and Demand Inpatient care business.industry 030208 emergency & critical care medicine Emergency department Middle Aged Intensive care unit Patient Discharge Emergency medicine Wounds and Injuries Injury Severity Score Female Surgery Emergency Service Hospital business |
| Zdroj: | Journal of Trauma and Acute Care Surgery. 89:940-946 |
| ISSN: | 2163-0763 2163-0755 |
| Popis: | Returning patients to preinjury status is the goal of a trauma system. Trauma centers (TCs) provide inpatient care, but postdischarge treatment is fragmented with clinic follow-up rates of30%. Posttraumatic stress disorder (PTSD) and depression are common, but few patients ever obtain necessary behavioral health services. We postulated that a multidisciplinary Center for Trauma Survivorship (CTS) providing comprehensive care would meet patient's needs, improve postdischarge compliance, deliver behavioral health, and decrease unplanned emergency department (ED) visits and readmissions.Focus groups of trauma survivors were conducted to identify issues following TC discharge. Center for Trauma Survivorship eligible patients are aged 18 to 80 years and have intensive care unit stay of2 days or have a New Injury Severity Score of ≥16. Center for Trauma Survivorship visits were scheduled by a dedicated navigator and included physical and behavioral health care. Patients were screened for PTSD and depression. Patients screening positive were referred for behavioral health services. Patients were provided 24/7 access to the CTS team. Outcomes include compliance with appointments, mental health visits, unplanned ED visits, and readmissions in the year following discharge from the TC.Patients universally felt abandoned by the TC after discharge. Over 1 year, 107 patients had 386 CTS visits. Average time for each appointment was1 hour. Center for Trauma Survivorship "no show" rate was 17%. Eighty-six percent screening positive for PTSD/depression successfully received behavioral health services. Postdischarge ED and hospital admissions were most often for infections or unrelated conditions. Emergency department utilization was significantly lower than a similarly injured group of patients 1 year before the inception of the CTS.A CTS fills the vast gaps in care following TC discharge leading to improved compliance with appointments and delivery of physical and behavioral health services. Center for Trauma Survivorship also appears to decrease ED visits in the year following discharge. To achieve optimal long-term recovery from injury, trauma care must continue long after patients leave the TC.Therapeutic, Level III. |
| Databáze: | OpenAIRE |
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