Author:

Publisher: Jeffrey Frank Jones

Published: 2018-10-09

Total Pages: 996

ISBN-13:

Almost 1,000 total pages; see index at beginning of publications for a complete list of included CPGs. Each CPG includes a section on the following: 1. GOAL 2. BACKGROUND 3. EVALUATION 4. TREATMENT 5. PERFORMANCE IMPROVEMENT (PI) MONITORING 6. SYSTEM REPORTING & FREQUENCY 7. RESPONSIBILITIES & 8. REFERENCES. OVERVIEW Clinical Practice Guidelines (CPGs) are the backbone of the system-wide JTS Performance Improvement program. Health data abstracted from patient records and after action reports is analyzed and distilled into globally relevant CPGs to remove medical practice variations and prevent needless deaths. The CPGs compiled from DoDTR data and used by healthcare providers worldwide are largely responsible for the decreased Case Fatality Rate for the wars in Iraq and Afghanistan. Examples are better transfusion practices; reduced burn morbidity and mortality; near elimination of extremity compartment syndrome; better patient care documentation; and improved communication across the spectrum of care between geographically dispersed facilities. CPGs are evidence-based and developed with experts in the military and civilian communities, deployed clinicians, Service trauma/surgical consultants, JTS leadership and formerly deployed Trauma Directors and Coordinators. JTS has a formalized process for developing, reviewing, updating, and approving CPGs. The guidelines are developed and implemented by clinical subject matter experts in response to needs identified in the military area of responsibility. CPGs were developed originally for U.S. Central Command. However, collaborative efforts are ongoing with the other Combatant Commands to customize CPGs to their COCOMs. INTRODUCTION TO THE JOINT TRAUMA SYSTEM (JTS) The Joint Trauma System (JTS) is the Department of Defense (DoD) authority for the military’s trauma care system. The vision of the Joint Trauma System is that every Soldier, Sailor, Marine and Airman injured on the battlefield will have the optimum chance for survival and maximum potential for functional recovery. To achieve this vision, in 2006, the JTS implemented programs for data -driven trauma system development and improvement in addition to the collection of trauma data. As part of its data collection efforts, the JTS maintains a registry of trauma patients who received care at medical treatment facilities (MTFs). Since 2007, this registry – known as the DoD Trauma Registry (DoDTR) – has documented demographic, injury, treatment, and outcomes data for all trauma patients admitted to any DoD MTF, regardless of whether the injury occurred during on-going military operations, and is the largest military trauma data source in the world. Development of the DoDTR began during the early years of the Global War on Terror (GWoT) when the need to systematically improve trauma care for combat wounded resulted in the impromptu creation of a demonstration registry, known then as the Combat Trauma Registry (CTR). The CTR was constructed by the Center for AMEDD Strategic Studies (CASS); trauma-related information was initially abstracted into it from paper medical records received from trauma nurse coordinators (TNCs) at Landstuhl Regional Medical Center (LRMC) in Germany. Shortly after the demonstration program started, the Army Surgeon General approved its transition to an operational mode, leading to the formation of the Joint Theater Trauma System (JTTS) and, eventually, the Joint Trauma System (JTS).