Improving Trauma Outcomes:A Patient Centered Approach

Johns Hopkins University, Baltimore MD

Investigators

Linked publications & trials

Abstract

Despite substantial improvements over the last two decadesin the organization and delivery of[unreadable] trauma care, severe injuries often result in poor longterm functional outcomes for working age individuals.[unreadable] Several studies have highlighted the limits of medical treatment alone and demonstrated that larger[unreadable] improvements in outcome will only be possible through interventions that also address the psychosocial[unreadable] needs of patients and assist them in self-managing the multi-factorial consequences of their injury.[unreadable] Intervention: It is in this context that the American Trauma Society developed the Trauma Survivor's Network[unreadable] (TSN) Program, a patient centered intervention designed to fill critical gaps in the care and rehabilitation of[unreadable] trauma survivors. The TSN program consists of four integrated components - health care provider training,[unreadable] efficient access to information and referral, a peer support program, and a self management course - linked[unreadable] together through a customized Information Technology application. Objectives: The purpose of this study is[unreadable] to evaluate the TSN. We will: (1) determine the use and satisfaction with services made available through[unreadable] the TSN Program; and (2) evaluate the effectiveness of the TSN Program in improving primary, secondary[unreadable] and intermediary outcomes for trauma patients. Study Design and Participants: The prospective clinical trial[unreadable] will use a pretest-posttest lagged-control design to evaluate the TSN. A total of 324 patients will be enrolled[unreadable] prior to implementation of the TSN at two Level I trauma centers. These individuals will serve as the control[unreadable] groupand their outcomes assessed at 9 months post-injury. Following implementation of the TSN at both[unreadable] trauma centers, a second cohort of 540 patients will be enrolled and followed at 9 months post-injury. These[unreadable] individuals will serve as the intervention group. Outcomes: Primary measures of effectiveness will include:[unreadable] self-reported pain, anxiety, PTSD, depressed mood, and positive mood. Secondary outcome measures[unreadable] include: function, return to usual major activity and quality of life. Improvements in primary and secondary[unreadable] outcomes will result through the impact of the intervention on self efficacy, patient activation and knowledge,[unreadable] catastrophizing and social support. If shown to be effective, the TSN will provide an additional critical[unreadable] component to the care now available in trauma centers throughout the country and ensure comprehensive[unreadable] patient centered trauma management to improve long-term outcomes and quality of life.[unreadable]