Memorial Hermann Health System recently launched a new Ground-to-OR process to reduce the time it takes for critically ill or injured patients to receive treatment in the operating room. Based on the successful Memorial Hermann Life Flight Helipad-to-OR process initiated at Memorial Hermann-Texas Medical Center in 2018, the Ground-to-OR process enables paramedics to transport qualifying patients more quickly from the ambulance, through the Emergency Center, and into the OR.
“Time matters in critical care,” says Michael Wandling, MD, MS, FACS, interim trauma medical director at the Red Duke Trauma Institute at Memorial Hermann Hospital-Texas Medical Center. “We know that every minute we can save in achieving hemorrhage control improves survival. This program helps minimize the time it takes to get patients to the OR, where life-threatening bleeding can be stopped.”
Since the program launched, successful outcomes have been linked to the time savings. Patients typically remain in the ER for no more than four minutes, before being transported to the OR within six minutes of arrival at the hospital, where surgery can begin almost immediately.
Memorial Hermann has developed a protocol that identifies appropriate trauma patients who can greatly benefit from beginning critical surgical interventions sooner. This process can help save lives for some of the most severely injured trauma patients, including those with penetrating wounds to the chest, abdomen or back who are in hemorrhagic shock.
The Ground-to-OR process shares many similarities with Helipad-to-OR, and both programs help patients receive care faster; however, the new Ground-to-OR process does not entirely bypass the ER.
“If we are walking right past trauma bays with X-ray machines that can rapidly provide us with important information, it benefits the patients to stop there first,” says Dr. Wandling. “Making this pit stop adds a very short time delay, but the benefits of increased information are worth it.”
Ground-to-OR starts the same way as any other call. When a patient is identified on scene as a good candidate, paramedics call in the report and Memorial Hermann’s triage team activates the process. Paramedics arrive at the trauma bay, as usual, but the process works differently from there.
After a quick X-ray and ultrasound while the patient remains on the EMS stretcher, paramedics stay with the Memorial Hermann team to move the patient from the ER to OR and from the stretcher to the operating table. The team then discusses the EMS report and completes the primary survey while the patient is being moved to the OR, where surgery can begin immediately.
Susannah “Meg” Michael, MSN-Ed., RN, TCRN, Memorial Hermann adult trauma program manager, says collaboration is key to saving lives. “The earlier we receive notification the patient is coming, the better. Even just a minute can make a difference with this process. There is so much that goes on behind the scenes to make this happen, and paramedics are the first step that gets everything in motion.”
“It all starts with the first responders,” Dr. Wandling added. “Our EMS agencies in Greater Houston are at the cutting edge of prehospital care and help define the way things are done nationally. We count on their expertise to continue to move the needle in optimizing prehospital trauma care as a city and trauma system.”
For more information, please visit trauma services at Memorial Hermann.