• Avneesh Bhangu, Lowyl Notario, Ruxandra L Pinto, Dylan Pannell, Will Thomas-Boaz, Corey Freedman, Homer Tien, Avery B Nathens, and da LuzLuisLTory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada..
• School of Medicine, Faculty of Health Sciences, Queen's University, Unit 505 - 91 King Street East, Kingston, ON, K7L 2Z8, Canada. abhangu@qmed.ca.
• CJEM. 2022 Jun 1; 24 (4): 419-425.

ObjectivesCommunication among trauma team members in the trauma bay is vulnerable to errors, which may impact patient outcomes. We used the previously validated trauma-non-technical skills (T-NOTECHS) tool to identify communication gaps during patient management in the trauma bay and to inform development strategies to improve team performance.MethodsTwo reviewers independently assessed non-technical skills of team members through video footage at Sunnybrook Health Sciences Centre. Team performance was measured using T-NOTECHS across five domains using a five-point Likert scale (lower score indicating worse performance): (1) leadership; (2) cooperation and resource management; (3) communication and interaction; (4) assessment and decision making; (5) situation awareness/coping with stress. Secondary outcomes assessed the number of callouts, closed loop communications and parallel conversations.ResultsThe study included 55 trauma activations. Injury severity score (ISS) was used as a measure of trauma severity. A case with an ISS score ≥ 16 was considered severe. ISS was ≥ 16 in 37% of cases. Communication and interaction scored significantly lower compared to all other domains (p < 0.0001). There were significantly more callouts and completed closed loop communications in more severe cases compared to less severe cases (p = 0.017 for both). Incomplete closed loop communications and parallel conversations were identified, irrespective of case severity.ConclusionA lower communication score was identified using T-NOTECHS, attributed to incomplete closed loop communications and parallel conversations. Through video review of trauma team activations, opportunities for improvement in communication can be identified by the T-NOTECHS tool, as well as specifically identifying callouts and closed loop communication. This process may be useful for trauma programs as part of a quality improvement program on communication skills and team performance.© 2022. The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).

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