Pediatric Trauma

Pediatric trauma teams care for injured children, utilizing a wide variety of pediatric services and staff. Trauma patients can range from children hurt in high-speed motor vehicle accidents to those injured while playing on the playground. A pediatric trauma team includes pediatric general surgeons, pediatric orthopedic surgeons, pediatric neurosurgeons, pediatric radiologists, and the many other physicians, nurses, and health care professionals who may be needed to care for pediatric trauma patients.

C.S. Mott Children's Hospital is a Level I Pediatric Trauma Centers verified by the American College of Surgeons to care for the most seriously injured children. From pre-hospital and emergency care to rehabilitation and prevention, our status as a Level I Pediatric Trauma Center provides the community with the highest level of expertise in care of the injured child through research and education.

Mott provides 24 hour access to a comprehensive team of pediatric trauma specialists who care for major and minor injuries. This specially trained team assesses every child as if he or she had a life-threatening injury, using a carefully developed trauma protocol. This systematic assessment helps to minimize the chance that an injury will be missed.

Volume is often used to assess clinical experience, expertise, and reputation with other providers in the community. Unfortunately, there is no standard or agreed upon threshold that defines high volume, so it is important to consider volume along with other measures, like process and outcome measures.

Pediatric Trauma Patient Volume

Details

Why is This Measure Important?

Volume is often used to assess clinical experience, expertise, and reputation. Unfortunately, there is no standard or agreed upon threshold that defines high volume, so it is important to consider volume along with other measures, like process and outcome measures. This is a measure of the volume of patients that were admitted to the Pediatric Trauma Service.

How is UMHS Performing?

Our volume of trauma patients tends to be lower than that of many other pediatric hospitals in the country because there are other trauma centers in Michigan that treat these patients. But, the severity of injury for our patients is higher. This is because more than 50% of the trauma patients we treat are transferred from another pediatric hospital rather than straight from the scene of the injury.

UMHS Source: Hospital trauma registry.

The following graphs describe the performance of the University of Michigan Health System by measuring the extent to which we follow best practices when treating trauma patients. Higher values mean better performance.

Time of Surgeon Arrival
Higher Value = Better Performance

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Why is This Measure Important?

The American College of Surgeons Committee on Trauma publishes standards for the response time of a trauma surgeon to a trauma patient that arrives in the emergency department. The guidelines are intended to assure that patients are treated with appropriate resources before their condition worsens. National standards specify that 80% of trauma patients be seen within the required timeframe: 15 minutes for Class I trauma (most severe) and 2 hours for Class II trauma.

How is UMHS Performing?

Although the national standards specify that 80% of trauma patients be seen within the required timeframe, we have set an internal expectation at UMHS that response time be met for 100% of patients.

We conduct a detailed review of every instance surgeons do not arrive within the expected time frame. These reviews often reveal that the surgeons were present very soon after the expected time. The findings from these reviews are used to develop ways to improve our process so that we can meet our target of 100%.

UMHS Source: Hospital trauma registry.
Comparison Group Source: American College of Surgeons National Trauma Data Bank (NTDB).

In this section, we evaluate outcomes following treatment of trauma patients by measuring rates of unplanned events, which can occur if patients are not properly assessed or given timely treatment. Lower values mean better performance.

Unplanned Operating Room Procedure or Transfer to ICU
Higher Value = Better Performance

Details

Why is This Measure Important?

Proper assessment and timely treatment is essential to a successful recovery for a trauma patient. When the proper care for trauma patients is not delivered, the patient's condition can worsen and result in unplanned procedures. Lower rates of unplanned operating room procedures and transfers to the intensive care unit (ICU) from a general care floor within 24 hours of admission are indicators of proper assessment of patient needs. The American College of Surgeons national standard specifies a threshold of 20% of patients or fewer with an unplanned operating room procedure or ICU transfer.

How is UMHS Performing?

Although the national standard specifies a threshold of 20% of patients or fewer with an unplanned operating room procedure or ICU transfer, we have set an internal expectation at UMHS that 0% of patients have either of these unplanned events. Because of our improvement efforts, 2% or fewer operating room procedures and ICU transfers within 24 hours of admission were unplanned. Our most recent results show that we reached our goal of 0% for both unplanned operating room procedures and ICU transfers.

UMHS Source: Hospital trauma registry.