What Is the Clinical Evidence Supporting Trauma Team Training (TTT): A Systematic Review and Meta-Analysis

<i>Background and Objectives:</i> Major trauma centres manage severely injured patients using multi-disciplinary teams but the evidence-base that targeted Trauma Team Training (TTT) improves patients&#8217; outcomes is unclear. This systematic review aimed to identify the association...

Full description

Bibliographic Details
Main Authors: Michael Noonan, Alexander Olaussen, Joseph Mathew, Biswadev Mitra, De Villiers Smit, Mark Fitzgerald
Format: Article
Language:English
Published: MDPI AG 2019-08-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1010-660X/55/9/551
_version_ 1827840826591412224
author Michael Noonan
Alexander Olaussen
Joseph Mathew
Biswadev Mitra
De Villiers Smit
Mark Fitzgerald
author_facet Michael Noonan
Alexander Olaussen
Joseph Mathew
Biswadev Mitra
De Villiers Smit
Mark Fitzgerald
author_sort Michael Noonan
collection DOAJ
description <i>Background and Objectives:</i> Major trauma centres manage severely injured patients using multi-disciplinary teams but the evidence-base that targeted Trauma Team Training (TTT) improves patients&#8217; outcomes is unclear. This systematic review aimed to identify the association between the implementation of TTT programs and patient outcomes. <i>Materials and Methods</i>: We searched OVID Medline, PubMed and The Cochrane Library (CENTRAL) from the date of the database commencement until 10 of April 2019 for a combination of Medical Subject Headings (MeSH) terms and keywords relating to TTT and clinical outcomes. Reference lists of appraised studies were also screened for relevant articles. We extracted data on the study setting, type and details about the learners, as well as clinical outcomes of mortality and/or time to critical interventions. A meta-analysis of the association between TTT and mortality was conducted using a random effects model. <i>Results</i>: The search yielded 1136 unique records and abstracts, of which 18 full texts were reviewed. Nine studies met final inclusion, of which seven were included in a meta-analysis of the primary outcome. There were no randomised controlled trials. TTT was not associated with mortality (Pooled overall odds ratio (OR) 0.83; 95% Confidence Interval; 0.64&#8722;1.09). TTT was associated with improvements in time to operating theatre and time to first computerized tomography (CT) scanning. <i>Conclusions</i>: Despite few publications related to TTT, its introduction was associated with improvements in time to critical interventions. Whether such improvements can translate to improvements in patient outcomes remains unknown. Further research focusing on the translation of standardised trauma team reception &#8220;actions&#8221; into TTT is required to assess the association between TTT and patient outcome.
first_indexed 2024-03-12T07:41:11Z
format Article
id doaj.art-0824efb0689748098a8a2be32b65b2fd
institution Directory Open Access Journal
issn 1010-660X
language English
last_indexed 2024-03-12T07:41:11Z
publishDate 2019-08-01
publisher MDPI AG
record_format Article
series Medicina
spelling doaj.art-0824efb0689748098a8a2be32b65b2fd2023-09-02T21:16:59ZengMDPI AGMedicina1010-660X2019-08-0155955110.3390/medicina55090551medicina55090551What Is the Clinical Evidence Supporting Trauma Team Training (TTT): A Systematic Review and Meta-AnalysisMichael Noonan0Alexander Olaussen1Joseph Mathew2Biswadev Mitra3De Villiers Smit4Mark Fitzgerald5National Trauma Research Institute, Melbourne 3004, AustraliaNational Trauma Research Institute, Melbourne 3004, AustraliaNational Trauma Research Institute, Melbourne 3004, AustraliaNational Trauma Research Institute, Melbourne 3004, AustraliaEmergency &amp; Trauma Centre, The Alfred Hospital, Melbourne 3004, AustraliaNational Trauma Research Institute, Melbourne 3004, Australia<i>Background and Objectives:</i> Major trauma centres manage severely injured patients using multi-disciplinary teams but the evidence-base that targeted Trauma Team Training (TTT) improves patients&#8217; outcomes is unclear. This systematic review aimed to identify the association between the implementation of TTT programs and patient outcomes. <i>Materials and Methods</i>: We searched OVID Medline, PubMed and The Cochrane Library (CENTRAL) from the date of the database commencement until 10 of April 2019 for a combination of Medical Subject Headings (MeSH) terms and keywords relating to TTT and clinical outcomes. Reference lists of appraised studies were also screened for relevant articles. We extracted data on the study setting, type and details about the learners, as well as clinical outcomes of mortality and/or time to critical interventions. A meta-analysis of the association between TTT and mortality was conducted using a random effects model. <i>Results</i>: The search yielded 1136 unique records and abstracts, of which 18 full texts were reviewed. Nine studies met final inclusion, of which seven were included in a meta-analysis of the primary outcome. There were no randomised controlled trials. TTT was not associated with mortality (Pooled overall odds ratio (OR) 0.83; 95% Confidence Interval; 0.64&#8722;1.09). TTT was associated with improvements in time to operating theatre and time to first computerized tomography (CT) scanning. <i>Conclusions</i>: Despite few publications related to TTT, its introduction was associated with improvements in time to critical interventions. Whether such improvements can translate to improvements in patient outcomes remains unknown. Further research focusing on the translation of standardised trauma team reception &#8220;actions&#8221; into TTT is required to assess the association between TTT and patient outcome.https://www.mdpi.com/1010-660X/55/9/551Trauma Team Trainingwounds and injurieseducationsimulationmortality
spellingShingle Michael Noonan
Alexander Olaussen
Joseph Mathew
Biswadev Mitra
De Villiers Smit
Mark Fitzgerald
What Is the Clinical Evidence Supporting Trauma Team Training (TTT): A Systematic Review and Meta-Analysis
Medicina
Trauma Team Training
wounds and injuries
education
simulation
mortality
title What Is the Clinical Evidence Supporting Trauma Team Training (TTT): A Systematic Review and Meta-Analysis
title_full What Is the Clinical Evidence Supporting Trauma Team Training (TTT): A Systematic Review and Meta-Analysis
title_fullStr What Is the Clinical Evidence Supporting Trauma Team Training (TTT): A Systematic Review and Meta-Analysis
title_full_unstemmed What Is the Clinical Evidence Supporting Trauma Team Training (TTT): A Systematic Review and Meta-Analysis
title_short What Is the Clinical Evidence Supporting Trauma Team Training (TTT): A Systematic Review and Meta-Analysis
title_sort what is the clinical evidence supporting trauma team training ttt a systematic review and meta analysis
topic Trauma Team Training
wounds and injuries
education
simulation
mortality
url https://www.mdpi.com/1010-660X/55/9/551
work_keys_str_mv AT michaelnoonan whatistheclinicalevidencesupportingtraumateamtrainingtttasystematicreviewandmetaanalysis
AT alexanderolaussen whatistheclinicalevidencesupportingtraumateamtrainingtttasystematicreviewandmetaanalysis
AT josephmathew whatistheclinicalevidencesupportingtraumateamtrainingtttasystematicreviewandmetaanalysis
AT biswadevmitra whatistheclinicalevidencesupportingtraumateamtrainingtttasystematicreviewandmetaanalysis
AT devillierssmit whatistheclinicalevidencesupportingtraumateamtrainingtttasystematicreviewandmetaanalysis
AT markfitzgerald whatistheclinicalevidencesupportingtraumateamtrainingtttasystematicreviewandmetaanalysis