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protocols, clinical guidelines and pathways

McSwain, Norman E nmcswai at tulane.edu
Thu Dec 30 16:44:07 GMT 2010

We have several guidelines/protocols. We tend not to use protocols, if
possible, just guidelines. However we do use activation protocols and
MTP. Any guidelines and changes are a product of the Spirit of Charity
Trauma Center, trauma committees. The are two committees one consist of
almost every section or department that touches the patient (OR, Anes,
blood bank, ICU, OR, ED {physicians and nurses] medical records, trauma
registry, etc) and a separate physician committee to handle peer review
and any medical changes in guidelines/protocols and specific patient
care problems of a physician nature. Each committee meets weekly. 

This process works very well for use. We feel that we are never more
than 7 days from addressing problems by all those who need input. Such a
process certainly reduces turf battles. It forces all who provide care
to think of patient care first.


Professor, Tulane University, Surgery
Trauma Director, Spirit of Charity Trauma Center, ILH/MCLNO
New Orleans, Louisiana
504 988 5111

-----Original Message-----
From: trauma-list-bounces at trauma.org
[mailto:trauma-list-bounces at trauma.org] On Behalf Of caesar ursic
Sent: Tuesday, December 28, 2010 7:52 PM
To: Trauma-List [TRAUMA.ORG]
Subject: protocols, clinical guidelines and pathways

   1. How many of you practice in an institution with established trauma
   clinical guidelines and / or protocols?
   2. What are they?  I would assume that Massive Transfusion Protocols
   Trauma Triage / Activation protocols are among the most prevalent.
   others? Please list a few (titles only, not the whole thing).
   3. Who develops and approves them? How are they enforced?  By whom?
   happens when they are ignored?
   4. Do you feel that they are important, or even essential, to
   best care possible?  If so, do you have any evidence (other than just
   anecdotal) that they are essential to good care?

 Of possible interest and relevance (a well-written two page
editorial):  *Alpert
JS, A review of clinical guidelines with some thoughts about their
and appropriate use.  Am J Med. 2010 Feb;123(2):97-8.*


CM Ursic, MD
trauma-list : TRAUMA.ORG
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