Effectiveness of Fast Track System Development in Head Injury Patients

Abstract

Background and Objectives: Head injury is one of the most common causes of injury-related morbidity and mortality. The purposes of this study were to examine the effectiveness of fast track system  development, regarding to clinical and  system development outcomes, in head injury patients.

Methods: The research and development study was conducted in participants who had severe head injury and admitted to the surgery department of Roi-Et Hospital from April 2011 to April 2014. A purposive sampling of 60 patients (30 for retrospective and 30 for prospective group) were recruited for the study. Both groups were evaluated for age, gender, intracranial injury type, and treatment. Head injury fast track system development included identifying problem, evidence based medicine electronic searches and select, protocol development, implementing protocol, and evaluation of system and outcomes. Instruments used to collect data included head injury passport, Glasgow coma scale, and Glasgow outcome scale of recording form. Descriptive statistics, Independent t-test and Chi-Square were used to analyze data.

Results: The results showed the prospective group had the Door to operation time for surgery less than four hours (mean of 3 hours 28 minutes). After surgery 1, 3, 7, 14 day and before discharge, level of Glasgow coma scale in the prospective group was increased more than that of the retrospective group in every period (p<0.05). In addition, at discharge the level Glasgow outcome scale of the prospective group was increased more than that of the retrospective group (p<0.05). And length of stay of the prospective group was less than that of  the retrospective group (p<0.05).

Conclusions: The Door to operation time for surgery was less than four hours and effectively increase recovery outcome and decreased length of stay in head injury clinic patients. This study suggest the benefits of  head injury fast track system for caring patients with head injury regarding hospital and patients outcomes.