Right patient, right place, right time

Worldwide, nearly 12 million people die each year of traumatic injuries. Part of the mission of trauma centers is to reduce those numbers by ensuring that every injured person receives the most appropriate care in the shortest possible time. At Mayo Clinic, clearly defined trauma activation criteria play a crucial role in meeting that goal.

Donald Jenkins, M.D., trauma director for the Level I Trauma Center at Saint Marys Hospital in Rochester, Minn., says that the criteria are designed and continuously refined to identify the most seriously injured people. "Once we know a person's condition, it takes just minutes to assemble the resources and multidisciplinary team needed to provide lifesaving care," says Dr. Jenkins.

The criteria also determine the makeup of the team. For instance, a pharmacist, transfusion nurses and operating room personnel are present for a Level I activation, but not for a Level II activation.

Referring community hospitals benefit from trauma activation guidelines, too, because the criteria help trauma specialists determine which patients require immediate transfer to a center that provides definitive care. "Transporting critically injured patients to the right place as soon as possible improves outcomes and saves lives," says Dr. Jenkins.

Saint Marys Hospital actively provides and solicits feedback from its referring hospital partners. "We ask folks how we could have done better," Dr. Jenkins says, "but we also tell people what we're doing and show them the results. Mayo's outcomes far exceed national standards. The expected mortality for trauma patients is 4.5 to 5 percent. At Mayo, that rate is less than 3 percent."

Some aspects of trauma care can't be controlled. "We can't change physics," Dr. Jenkins notes. "We can't make ambulances or helicopters go faster. What we can do is shorten the decision-making process. With the correct transfer and triage criteria in place, we ensure that the right patient is treated at the right place at the right time."