Does use of a trauma checklist increase discharges from the emergency department?

• Published in: Trauma (London, England) England), 2018-01, Vol.20 (1), p.52-57
• Main Authors: Jambhekar, Amani, Lindborg, Ryan, Chan, Vincent, Laskey, Daniel, Rucinski, James, Fahoum, Bashar
• Format: Article
• Language: English
• Subjects: Emergency medical services; Emergency services; Health care; Injuries; Patients; Trauma
• ISSN: 1460-4086; 1477-0350
• DOI: 10.1177/1460408617698510

Introduction Emergency department (ED) discharge is appropriate for patients with minor traumatic injuries. The objective of this study is to determine if use of a trauma checklist increases identification of patients with minor trauma who are safe for discharge. Methods Data were collected on trauma patients evaluated between 1 April 2015 and 31 January 2016 in two groups before and after introduction of a trauma checklist. The two groups were compared using age, mechanism of injury, and Injury Severity Score (ISS) using unpaired Student t-tests and Fisher’s exact test. Results A total of 841 trauma patients were included; 197 prior to the introduction of the checklist and 644 afterwards. Following the implementation of the trauma checklist, significantly more patients were discharged from the ED (18.2% vs. 7.6%, p = 0.0004). Discharged patients in the pre- and post-checklist groups had similar ISS (1.93 ± 1.49 vs. 1.87 ± 1.90, p = 0.90) and were of similar age (35.27 ± 11.06 vs. 41.99 years ± 18.20, p = 0.17). There was no increase in ‘bounce-backs’ to the ED in the post checklist group despite a significantly higher rate of discharge. Conclusion Use of a trauma checklist allows for better identification of those trauma patients who are safe to discharge from the ED and widespread use may decrease healthcare costs.