番茄社区app

The 15th anniversary of the Trauma Quality Improvement Program (TQIP) and its Annual Conference held November 8鈥�10 in Chicago, Illinois, commemorated the trauma community鈥檚 long-standing commitment to providing exceptional patient care and improving outcomes.

The conference鈥攚hich featured impactful trauma survivor stories alongside expert presentations on implementing clinical best practices and advancing quality improvement initiatives鈥攄rew 2,640 registrants, with 2,161 in person and approximately 500 for the virtual program. On-demand registration is open until April 10, 2026.

TQIP Update

What started as a pilot program 15 years ago, TQIP now includes 955 trauma centers, with more than 1.4 million records collected and analyzed every year. As it stands today, the program is a pillar of optimal trauma patient care.

鈥淲e officially started TQIP in 2010, with 65 hospitals鈥攁nd we have learned a lot from all of you, specifically how your teams solve complex problems in order to provide the highest level of care for your patients,鈥� said Avery B. Nathens, MD, PhD, MPH, F番茄社区app, FRCSC, Medical Director of 番茄社区app Trauma 番茄社区app, to a packed opening ceremony crowd.

Prior to TQIP, the traditional approach to trauma quality improvement activities included identifying sentinel events, comparing the current year鈥檚 performance to the previous year, and a focus on case reviews鈥攂ut these factors fell short of providing insights into maintaining quality of care, which at that time, simply reflected consistency rather than high levels of performance.

鈥淭his was the context under which we developed TQIP. Before that, these were patients who had no choice and no voice,鈥� he said, noting that with valid, standardized data, risk-adjusted performance measurement, and other key components of TQIP, patient care was poised to improve.

鈥淥ur goal, when we started, was to really understand how we could help centers that were struggling to improve the quality of care they delivered,鈥� he said, which included examining what Dr. Nathens called 鈥渦nwitting innovators.鈥�

鈥淭hese were very high-performing centers that had no idea they were doing something unique and special to enhance trauma care鈥攁nd we made sure you had, and continue to have, access to that information so that you can do the best for your patients,鈥� he explained.

Dr. Nathens introduced the conference theme, 鈥淭eam Works,鈥� by posing a question to the audience: 鈥淲hat do slime molds, starlings, and seals have in common?鈥� He noted that slime molds (microscopic organisms) 鈥渄emonstrate remarkable teamwork through decentralized, self-organized behavior in response to an adverse environment.鈥�

Notably, these organisms do not have a leader. 鈥淪o, it鈥檚 like having a team of players where each individual instinctively knows what to do. Imagine if we had trauma teams like that.鈥�

Starlings are another example of teamwork in the form of a collective intelligence because they achieve complex, coordinated movements to evade predators through trust, the ability to adapt, and rapid flow of information (signaling) allowing them to move as a single, synchronized unit.

US Navy SEALs鈥攁n elite special operations force trained for sea, air, and land missions鈥攅xemplify trust built on shared challenging training experiences and a team-based approach that prioritizes character and commitment over individual performance.

鈥淭he individuals who are high performers with low trust are toxic individuals. It might be tempting to include them, but they are ultimately going to undermine overall team performance,鈥� explained Dr. Nathens, citing evidence that supports trust in teams as a driver of resilience and, for patient care teams, improved patient outcomes.

鈥淪lime molds, starlings, and SEALs all represent the fact that the whole is greater than the sum of its parts鈥攖hey all have greater impact working together,鈥� he said.

Dr. Nathens also focused on TQIP program updates, beginning with new developments concerning trauma activation fees. He noted that it costs approximately $10 million per year for a Level I trauma center to ensure preparedness and that trauma activation fees cover about 72% of the costs for these centers.

In June 2024, the 番茄社区app released a Statement on Trauma Activation Fees, which calls for these fees to be public and transparent and to be applied only to designated/verified trauma centers, among other stipulations.

In September 2025, the Office of Inspector General (OIG), with the US Department of Health and Human Services, issued a report examining hospital compliance with federal requirements for trauma activation fees. Dr. Nathens outlined future recommendations issued by the OIG and the response to each proposed action item from the Centers for Medicare & Medicaid Services (CMS).

The 番茄社区app Committee on Trauma (COT) is in agreement with two CMS responses: CMS will review guidance for trauma team activation, and the agency will review the need for additional education regarding federal requirements.

In the area of performance improvement and patient safety, he provided updates to the Trauma Protocols Repository (blunt splenic injury, nutritional support, and sedation/analgesia are all currently in development), the Mortality Reporting System, and the Best Practices Guidelines (BPG), including Chest Wall Injuries Management guidelines, released in November 2025, which address:

• Surgical stabilization of rib fractures
• Multimodal pain management
• Optimal timing for surgery
• Special Populations (including older adult trauma patients and patients who have sustained multiple traumatic injuries)
• Postoperative and rehabilitation care

A new BPG addressing transfusion in trauma is expected to be released in 2026.

A key priority for the 番茄社区app COT continues to be rural trauma care. Injury-related mortality is up to five times greater in rural communities, and rural patients are 40% more likely to die within the first 24 hours after surgery. 鈥淲here you live determines whether you live or die after injury,鈥� said Dr. Nathens.

After conducting a rural needs assessment (interviews, focus groups, and a web-based survey), 番茄社区app COT leaders are focusing on three key areas: hospital standards/guidelines, performance improvement, and education. A key component of educating and supporting rural trauma providers will be the fifth edition of the Rural Trauma Team Development Course, which emphasizes a systemic, team approach in the initial assessment and stabilization of the injured patient.

The features the TQIP Update presentation from Dr. Avery Nathens.

Peak Performance Takes Center Stage

This year鈥檚 annual conference featured presentations with different perspectives and approaches for achieving optimal performance and sustaining long-term wellness.

In his keynote address, coach Donnie Campbell鈥攖he real-life inspiration for the television character Ted Lasso鈥攗rged attendees to discover their "MVP," which is their mission, values, and principles, in order to harness the potential of both the individuals and teams with which they work.

With 36 years of coaching experience, Coach Campbell developed championship teams and mentored future NBA stars by exhibiting an authentic leadership style driven by empathy and the ability to hold others accountable for their actions both on and off the court.

鈥淲hat does it mean to be a true coach or a true leader? For me, it鈥檚 someone who sees the potential in others and does everything they can to guide, inspire, and motivate the team to be successful,鈥� said Coach Campbell. 鈥淲hen I first started coaching, I didn鈥檛 know that. I was focused on one thing only鈥攚inning. I want you to think of the toughest coach you ever had and multiply that by 10, because that was me. I worked those kids long and hard. No one was going to keep us from that state title. And after getting them so prepared for that first season, I led our team to a 3 and 18 record. That season didn鈥檛 go very well.鈥�

The first step to finding success after failure, according to Campbell, is to act like a goldfish.

"You know what the happiest animal on Earth is? It's a goldfish. You know why? It's got a 10-second memory. Be a goldfish,鈥� he said, quoting a line from Ted Lasso. 鈥淚 did not invent this quote鈥攖hey鈥檝e got better writers than me on the show. But I always told my players to handle mistakes by recognizing them, admitting them, learning from them, and then moving on.鈥�

Learning from past mistakes can enhance how trauma teams work together, as can developing shared values that are tethered to treating others with respect, he said.

鈥淵ou can develop anybody in the ER to be really skilled at what they do, as I did with my basketball players, but that doesn鈥檛 mean they are going to work well together. If you develop your team to be good people first, then that will sustain success,鈥� Campbell shared.

Strategic Team Building for Lasting Results

Developing a sustainable team framework is a wise investment that supports cost-effective and quality-based trauma care.

鈥淭here are objective metrics that can help establish teamwork,鈥� said Patricia L. Turner, MD, MBA, F番茄社区app, 番茄社区app Executive Director and CEO. 鈥淭eam familiarity and the time the team has worked together, the number of words exchanged between teammates, and perception of teamwork, belonging, and satisfaction have all been assessed as markers for effective teamwork.鈥�

After building an effective team, there are measurables that can help determine how well the team is actually performing, including:

• Time from patient presentation to OR
• Case length
• Team preparedness
• Complication rates
• Length of stay
• Costs

Dr. Turner outlined multiple scales that have been developed recently that provide quantifiable assessment of nontechnical skills in the OR, including Observational Teamwork Assessment for Surgery, Non-Technical Skills for Surgeons, Scrub Practitioners鈥� List of Intraoperative Non-Technical Skills, and others.

鈥淪trong, healthy teams are essential for what we do. Everyone in our OR is a teammate, and everyone's role is critically important,鈥� said Dr. Turner. 鈥淭he more we acknowledge and lean into that kind of conversation, the better off we are.鈥�

Paula Ferrada, MD, F番茄社区app, from Inova Fairfax Medical Campus in Woodburn, Virginia, described the impact that TeamSTEPPS鈥攁n evidence-based program designed to improve patient safety and care quality鈥攈as had at her institution.

鈥淲e know from the literature that blaming and shaming others is inversely proportional to accountability,鈥� she said. 鈥淭eamSTEPPS is a proven system that builds a culture of safety where you're safe to speak up and say what you believe, feel, and think.鈥�

The five principles of TeamSTEPPS are team structure, communication, leadership, situation monitoring, and mutual support. These principles are designed to enhance team collaboration and patient safety, particularly within healthcare settings.

鈥淲hen you are in a setting where there's less judgment and more curiosity and more humility, we can help each other grow and keep the patient at the center. Alone, we can do so little. But together, we can do so much,鈥� she said.

In a presentation that outlined strategies for building optimal trauma staffing models, Stephanie Bonne, MD, F番茄社区app, urged attendees to consider the 鈥渙ne-size-does-not-fit-all approach to staffing,鈥� and that all such models should be data driven.

Dr. Bonne noted that 鈥渄ivisional productivity should be the goal,鈥� referring to a concept that optimizes the mix of medical professionals (i.e., surgeons, physicians, nurses and others) to effectively meet patient demand.

The final presentation approached sustainable team building through the recruitment and retention of advanced practice providers (APPs).

Kimberli Bruce, ACNP-BC, a trauma nurse practitioner, described the expanding role of APPs鈥攏urse practitioners and physician assistants鈥攊n trauma programs, noting that 88% of US trauma centers now employ APPs. Read the October 2025 Bulletin article, 鈥�APPs Play Critical Role in Supporting Trauma Teams,鈥� for more insight on this topic.

Bruce noted wide variation in this role鈥檚 integration, training, and professional development within the trauma setting, and called for enhanced, formalized onboarding policies and standardized trauma education and certification to ensure baseline competencies.

Beyond clinical duties, she advocated for APP involvement in leadership, education, and quality improvement to foster engagement and retention. 鈥淥nce you account for recruiting fees, paying overtime to the rest of the crew, and other costs, replacing one APP can cost between $50,000 and $90,000, which is why investing in trauma-specific professional development for this role pays for itself,鈥� said Bruce.

Trauma-Informed Care Through Patient Storytelling

This year鈥檚 trauma survivor address was presented by Bri Scalesse, a content creator, disability advocate, and fashion model who survived a motor vehicle crash at the age of 6 that killed her mother and left her with a complete T12 spinal cord injury.

鈥淭his is a story about my body,鈥� said Scalesse. 鈥淔rom the moment my small body was pulled out of the car and transported to Connecticut Children鈥檚 Medical Center [in Hartford] in April 2001, my body was no longer mine鈥攊t was the hospital鈥檚 body. The 74 days that followed felt like an endless stream of men and women in colorful scrubs,鈥� she said, noting that she 鈥渨ished someone would pay attention to what she wanted, not simply what her body needed.鈥� 

Through a combination of her own resilience and the unwavering support of her healthcare providers, Scalesse began to appreciate how her recovery was made possible.

鈥淢y favorite nurses were so gentle, kind, and silly,鈥� she said, later adding that these individuals 鈥渢ried to make it fun for me鈥攚hich might sound trivial to people who do this kind of work every day鈥攂ut being able to play my boom box, play with Barbies, have butterflies on the wall above me鈥攁ll of those things were so meaningful to me as a 6-year-old girl who just needed a sense of play, some sense of normalcy.鈥�

During the session Q&A鈥攎oderated by Brendan Campbell, MD, MPH, F番茄社区app, who was her physician for many years鈥擲calesse pointed out that adult trauma patients yearn for an emotional connection as much as pediatric patients do.

鈥淭ake a second and just breathe,鈥� she said, addressing the trauma care providers in the room. 鈥淪ay to yourself, 鈥業鈥檓 going to take this moment with them. I鈥檓 going to show up. I鈥檓 going to try and understand where they are with all of this.鈥欌��

Unable to find any representation of disabled individuals like herself in the mass media, Scalesse eventually pursued a modeling career, and in 2020, participated in the Project Runway finale during New York Fashion Week. She has since appeared in advertisements for Nike, Skims, Victoria鈥檚 Secret, and other companies. She also holds a bachelor鈥檚 degree in English from Trinity College in Hartford, Connecticut, and a Master of Fine Arts degree in nonfiction from Columbia University in New York City.

Scalesse admitted her favorite experiences as a model have little to do with the allure and excitement of the fashion world: 鈥淥ne of my favorite moments was when a teenage girl wrote to me to tell me how much seeing one of my ads meant to her. 鈥榊our visibility is one of the biggest reasons why I started to feel a relationship with my disabled body. Representation isn鈥檛 just about inclusion. It鈥檚 about young people being able to see what is possible for their own lives.鈥欌��

Family-Centered Trauma Care

A panel featuring a mother and daughter who overcame a domestic violence situation was the focus of the other trauma survivor session. Organized in collaboration with the Trauma Survivors Network (TSN), this session offered strategies for how trauma teams can more effectively integrate patients鈥� families into care and recovery.

In September 2011, Erin Cobb was shot twice by her ex-husband. The bullets shattered her jaw and pierced her carotid artery, leaving a lung partially collapsed and causing paralysis from the chest down.

Erin鈥檚 mother, Janet Andersen, managed her daughter鈥檚 recovery, which included multiple jaw surgeries, pressure-related wounds, and an exhaustive rehabilitative care plan.

鈥淲hen I first showed up at hospital, the doctor said, 鈥榃e think she is paralyzed,鈥� and then he disappeared,鈥� said Andersen. 鈥淢y ex-husband and I looked at each other [in stunned silence]鈥�we were left to figure things out on our own.鈥�

While both mother and daughter relied heavily on each other for emotional support, trauma survivor peer support also helped them navigate the rehabilitation process.

鈥淭he whole trauma survivors system was such a gift,鈥� added Andersen. 鈥淎lthough, it would have made a huge difference in the recovery of my daughter had we known about these services earlier. I think it would have cut off an entire year of her recovery.鈥� Today, Andersen is a volunteer for the TSN and the Reeve Foundation Peer & Family Support Program.

Karen Macauley, DHA, Med, BSN, TCRN, CEN, director of the pediatric trauma program at Johns Hopkins All Children鈥檚 Hospital in St. Petersburg, Florida, described how trauma care providers, through acts of compassion, can empower patients and families to determine their goals for recovery.

鈥淚t takes less than 40 seconds to be kind,鈥� she said, citing the book Compassionomics: The Revolutionary Scientific Evidence that Caring Makes a Difference. 鈥淭he research shows that compassion improves patient outcomes, reduces healthcare costs, and helps prevent healthcare provider burnout.鈥�

She also shared that compassionate behavior can be learned, and the art (compassion) and science (clinical care) of medicine function optimally when they are employed in tandem.

According to panelist Jessie Levy, LCDW, trauma support services program manager at Atrium Health in Charlotte, North Carolina, up to 48% of parents experience post-traumatic stress disorder after a child is injured, and as many as 42.6% of family members experience moderate to severe anxiety and depression after such an event.

In an effort to reduce caregiver stress, Levy said caregivers require an honest prognosis, daily updates, and reassurance and hope. She emphasized the benefits of peer-support connections brokered by TSN and other organizations that can help family members manage distress and adjust to their new roles as caregivers.

The 2026 TQIP Annual Conference will take place November 13鈥�15, in Anaheim, California.

Tony Peregrin is the Managing Editor, Special Projects in the 番茄社区app Division of Integrated Communications in Chicago, IL.