TRAUMA QUALITY IMPROVEMENT

Reliability of the STAT taxonomy using trauma video review

Published on

November 18, 2023

European Journal of Trauma and Emergency Surgery

Anisa Nazir, Nemanja Baletic, Ryan P Dumas, Caitlin Fitzgerald, Keying Xu, Melissa McGowan, Brodie Nolan
Anisa Nazir, Nemanja Baletic, Ryan P Dumas, Caitlin Fitzgerald, Keying Xu, Melissa McGowan, Brodie Nolan
Anisa Nazir, Nemanja Baletic, Ryan P Dumas, Caitlin Fitzgerald, Keying Xu, Melissa McGowan, Brodie Nolan

Overview

The STAT (Safety Threats and Adverse Events in Trauma) taxonomy categorizes 65 trauma resuscitation adverse events (AEs) into nine groups, facilitating standardized analysis and promoting quality improvement in patient safety. This study evaluates the reliability of the STAT taxonomy by analyzing high-definition videos from 30 trauma resuscitations, scored by four independent reviewers. Results indicated that the most frequent AEs included failure to measure temperature and inadequate personal protective equipment, both at 86.7%. The inter-rater agreement was exceptionally high at 0.94, with individual AE categories demonstrating strong reliability. These findings suggest that the STAT taxonomy is a robust tool for identifying AEs in trauma settings, supporting its use in objective video reviews for enhanced patient safety initiatives.

Results

The most common AEs identified in the videos were failure to measure temperature (86.7%) and inadequate personal protective equipment (86.7%), followed by inability to use closed-loop communication (76.7%). The agreement on all AEs between reviewers was 0.94 (95% CI: 0.93-0.95). The Gwet's AC1 agreement across the 9 AE categories was paramedic handover (0.82), airway and breathing (0.99), circulation (0.95), assessment of injuries (0.91), management of injuries (0.96), procedure-related (0.97), patient monitoring and IV access (0.99), disposition (0.98), team communication and dynamics (0.87).