‘How are we going to harm the next trauma patient?’ Trauma care providers’ perspective on potential harm to trauma patients

Background The question, “How will the next patient be harmed?” is a component of strategies used to identify latent safety risks in healthcare. We sought to survey a broad audience attending the 2023 annual conference of the American College of Surgeons–Trauma Quality Improvement Program to record...

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Main Authors: Galinos Barmparas, Todd W Costantini, Avery B Nathens, Aaron R Jensen, Babak Sarani, Bryce RH Robinson
Format: Article
Language:English
Published: BMJ Publishing Group 2025-05-01
Series:Trauma Surgery & Acute Care Open
Online Access:https://tsaco.bmj.com/content/10/2/e001628.full
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author Galinos Barmparas
Todd W Costantini
Avery B Nathens
Aaron R Jensen
Babak Sarani
Bryce RH Robinson
author_facet Galinos Barmparas
Todd W Costantini
Avery B Nathens
Aaron R Jensen
Babak Sarani
Bryce RH Robinson
author_sort Galinos Barmparas
collection DOAJ
description Background The question, “How will the next patient be harmed?” is a component of strategies used to identify latent safety risks in healthcare. We sought to survey a broad audience attending the 2023 annual conference of the American College of Surgeons–Trauma Quality Improvement Program to record their perception of the risks that might lead to patient harm at their own trauma centers.Methods Attendees were surveyed with a single free-text question “How are we going to harm the next patient?” using a quick response code. All responses were categorized into clustered themes. To report the results using a standardized reporting taxonomy, the responses were also classified according to the Joint Commission (JC) patient safety event taxonomy for near misses and adverse events. Results were reported as counts and as proportions of responders.Results During the 3-day duration of the conference, 64 participants provided 80 responses. Provider-related risk (n=16, 25.0%) was the most commonly reported category, followed closely by practice management guideline related (n=14, 21.9%) and communication gaps or failures (n=12, 18.8%). “Clinical performance” was the most commonly reported subclassification in the main category “type” of the JC patient safety event taxonomy (n=34, 53.1%), followed by patient management (n=30, 46.9%). “Human error” was the most common subclassification in the main category “cause” (n=48, 75.0%).Conclusions Human failures, rather than systems issues, were perceived to be responsible for the majority of potential harm in trauma patients by a broad audience of trauma care providers. These results require amplified focus on strategies that decrease the impact of the human element while enhancing process standardization and addressing barriers to the implementation of processes and guidelines. It might also suggest an opportunity to bring forward alternative conceptual frameworks to advance safety in trauma care.
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spelling doaj-art-8cf3a4855bef42aabf7c5fd276e2901b2025-08-20T03:09:42ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762025-05-0110210.1136/tsaco-2024-001628‘How are we going to harm the next trauma patient?’ Trauma care providers’ perspective on potential harm to trauma patientsGalinos Barmparas0Todd W Costantini1Avery B Nathens2Aaron R Jensen3Babak Sarani4Bryce RH Robinson5Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California, USADepartment of Surgery, Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery, University of California San Diego, San Diego, California, USAAmerican College of Surgeons, Chicago, IL, USAUCSF Benioff Children`s Hospital, San Francisco, California, USA2 Center of Trauma and Critical Care, The George Washington University, Washington, District of Columbia, USADepartment of Surgery, Harborview Medical Center, Seattle, Washington, USABackground The question, “How will the next patient be harmed?” is a component of strategies used to identify latent safety risks in healthcare. We sought to survey a broad audience attending the 2023 annual conference of the American College of Surgeons–Trauma Quality Improvement Program to record their perception of the risks that might lead to patient harm at their own trauma centers.Methods Attendees were surveyed with a single free-text question “How are we going to harm the next patient?” using a quick response code. All responses were categorized into clustered themes. To report the results using a standardized reporting taxonomy, the responses were also classified according to the Joint Commission (JC) patient safety event taxonomy for near misses and adverse events. Results were reported as counts and as proportions of responders.Results During the 3-day duration of the conference, 64 participants provided 80 responses. Provider-related risk (n=16, 25.0%) was the most commonly reported category, followed closely by practice management guideline related (n=14, 21.9%) and communication gaps or failures (n=12, 18.8%). “Clinical performance” was the most commonly reported subclassification in the main category “type” of the JC patient safety event taxonomy (n=34, 53.1%), followed by patient management (n=30, 46.9%). “Human error” was the most common subclassification in the main category “cause” (n=48, 75.0%).Conclusions Human failures, rather than systems issues, were perceived to be responsible for the majority of potential harm in trauma patients by a broad audience of trauma care providers. These results require amplified focus on strategies that decrease the impact of the human element while enhancing process standardization and addressing barriers to the implementation of processes and guidelines. It might also suggest an opportunity to bring forward alternative conceptual frameworks to advance safety in trauma care.https://tsaco.bmj.com/content/10/2/e001628.full
spellingShingle Galinos Barmparas
Todd W Costantini
Avery B Nathens
Aaron R Jensen
Babak Sarani
Bryce RH Robinson
‘How are we going to harm the next trauma patient?’ Trauma care providers’ perspective on potential harm to trauma patients
Trauma Surgery & Acute Care Open
title ‘How are we going to harm the next trauma patient?’ Trauma care providers’ perspective on potential harm to trauma patients
title_full ‘How are we going to harm the next trauma patient?’ Trauma care providers’ perspective on potential harm to trauma patients
title_fullStr ‘How are we going to harm the next trauma patient?’ Trauma care providers’ perspective on potential harm to trauma patients
title_full_unstemmed ‘How are we going to harm the next trauma patient?’ Trauma care providers’ perspective on potential harm to trauma patients
title_short ‘How are we going to harm the next trauma patient?’ Trauma care providers’ perspective on potential harm to trauma patients
title_sort how are we going to harm the next trauma patient trauma care providers perspective on potential harm to trauma patients
url https://tsaco.bmj.com/content/10/2/e001628.full
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