Projects & Initiatives
Projects
Trauma System Development and Performance- Collaborates with combatant commands (CCMDs) to develop a standardized CCMD Trauma System (CTS), facilitate continuing education opportunities/programs, and implement robust performance improvement programs for U.S. Central Command (CENTCOM), Indo-Pacific Command (INDOPACOM), Africa Command (AFRICOM), Southern Command (SOUTHCOM), and Northern Command (NORTHCOM).
- Participates in South Texas Regional Advisory Council (STRAC) to enhance local civilian trauma system based on military experiences.
Performs rapid PI data analytics and generates recommendations based on the DoD Trauma Registry (DoDTR) PI data analysis and review of After Action Reports.
- Conducts trauma outcomes data analysis.
- Monitors trauma care performance to:
- Identify process improvement opportunities.
- Identify opportunities to improve interoperability standards.
- Integrate PI processes into CTS development for all CCMDs.
- Provide resolution of trauma system Doctrine, Organization, Training, Materiel, Leadership and Education, Personnel, Facilities and Policy analysis issues.
- Executes the JTS Patient Safety program.
- Identifies and helps mitigate patient safety issues through the review of casualty care registry data and after action reports.
- Supports the Joint Patient Safety Reporting process.
- Organize and host conferences for CENTCOM, AFRICOM, INDOPACOM and the Armed Forces Medical Examiner System.
- Responsible for managing attendees for the Continuing Medical Education and Continuing Nurses Education programs.
- Incorporates clinical cases into Case Records of the Joint Trauma System panel discussions for multi-disciplinary academic conferences.
Clinical Practice Guidelines (CPGs)
Facilitates and manages the development and update of JTS CPGs with the assistance and expertise of the tri-service Defense Committee on Trauma.
Lessons Learned Program
Manages the collection/assessment of observations from operations, activities, and exercises in support of the DHA Joint Lessons Learned Program to enhance Joint Force readiness and effectiveness. Lesson Learned resources are compiled into the Trauma Care Resources portal and the JTS Community of Practice in the DoD Joint Lessons Learned Info System (JLLIS).
Pre-Hospital PI
Recommends, implements and promote best practices for combat casualty care through the use of After Action Report (AAR) reviews and evaluation of Tactical Combat Casualty Care (TCCC) performance.
- Socializes and promotes the JTS, CPGs, and develops PI Liaisons with pre-deploying teams to conduct PI efforts in theater.
- Provides ongoing support for teams before, during and after deployment.
- Provides formal JTS Performance Improvement Course for theater trauma leaders.
- Works with DHA and civilian medical system partners to build a systematic process for translating knowledge into practice.
- Designed and implemented a pilot project to examine Knowledge Translation best practices for disseminating guidelines, best practices, and lessons learned.
Joint Trauma and Education Training (JTET) Support
Works with the JTET arm of JTS to provide outreach education to prehospital (point of injury and Role 1), Role 2 and Role 3 training venues as well as tri-service medical curricula programs from basic to advanced lessons aligned with JTS CPGs.
Initiatives
Association of Prehospital Blood Product Transfusion during Medical Evacuation of Combat Casualties in Afghanistan with Acute and 30-Day Survival.
Retrospective cohort study of 502 US military combat casualties undergoing medical evacuation concluding that prehospital transfusion was associated with improved survival at 24 hours.
Causes of Death in Military Working Dogs (MWD) During Operations Iraqi Freedom (OIF) and Enduring Freedom (OEF), 2001 to 2013.
Study MWD injuries and then analyze related data to drive improvements in canine clinical care and preventive protective equipment. Project team is now collaborating with veterinary services to build a MWD registry.
Clinical Implications of Pharmacologic Alterations of Thrombosis following Severe & Penetrating Traumatic Brain Injury (TBI).
Evaluate the use of venous thromboembolism chemoprophylaxis (heparinoids) as well as pro-coagulant medications (i.e. TXA, Factor VII) in patients with severe closed and penetrating brain injury sustained in the wars in Iraq and Afghanistan. Project involves the creation of a comprehensive TBI module for data abstraction and data analysis.
Combat Abdominal Surgery during Recent Combat Operations from 2002-2016.
Gain a thorough understanding of abdominal surgical training gaps and personnel requirements by examining the frequency and type of abdominal surgical procedures performed in theater.
Combat Casualty Care Statistics.
Calculate annual case fatality rate, percent Died of Wounds, percent Killed in Action, and Injury Severity Score for all operations in Iraq and Afghanistan.
Combat Orthopedic Procedures Performed During Combat Operations 2002-2016.
Analysis identified the most common Role 2 and Role 3 procedures to pinpoint surgical training shortcomings.
Epidemiology & Trends of Injury among US Military Female Service Members in the Iraq, Afghanistan Wars.
Identifies injury trends and recognize patterns in injuries and mortality for women deployed to combat zones. Distinguish the classification, mechanisms, and dominant types of physical injuries sustained by deployed women.
The Effect of Prehospital Transport Time, Injury Severity & Blood Transfusion on Survival of US Military Casualties in Iraq.
Continues to explore how receiving required medical capabilities can mitigate morbidity and mortality in critically injured combat casualties.
Genitourinary (GU) Injury in Male OEF/OIF Veterans Receiving VA Healthcare: The Importance of Linking DoD & VA Data.
Look at the examined the long-term effects of GU injury on sexual, urinary, reproductive, and psychological outcomes. Describes how improved documentation of GU injury in DoD and VA is needed to alert multi-specialty care teams to tackle these outcomes.
Prolonged Field Care.
Identify and describe cases in the DoDTR with documented wait times of 4 hours or more for transport.
Re-examination of the Golden Hour Policy.
Decomposition analysis quantifying the extent of which factors, such as faster transport time, contributing to the decreased percent killed in action following the Golden Hour Mandate in Afghanistan.
South Command.
Compare causes of death among Special Operations Forces and other casualties.
Zero Preventable Deaths.
Perform a series of qualitative and quantitative performance improvement projects in order to recommend guidelines and standard operating procedures for military preventable death reviews.
Surveys
Craniectomy.Collect self-report data from surgeons regarding their experience in performing craniectomies or burr hole procedures in Role 2 or 3 without a neurosurgeon present. Predeployment Training.
Assess perceptions of training and readiness amongst military in terms of deployment. Gather opinions regarding the current predeployment training courses and query the deployable surgical population about potential opportunities for improvement in training for the trauma care mission performed downrange.