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Reliability of the safety threats and adverse events in trauma (STAT) taxonomy using trauma video review

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

The STAT (Safety Threats and Adverse Events in Trauma) taxonomy was developed through expert consensus, and groups 65 identified trauma resuscitation adverse events (AEs) into nine distinct categories. It provides a framework for standardized analysis of trauma resuscitations and creates a foundation for targeted quality improvement and patient safety initiatives. This study aims to evaluate the reliability of the STAT taxonomy in identifying AEs during video-recorded trauma resuscitations.

Methods

High-definition audiovisual data from 30 trauma resuscitations were reviewed. Videos were assessed and scored by four independent reviewers (two trainees and two staff). The STAT taxonomy was used to identify AEs based on binary responses: yes and no. Inter-rater reliability was calculated using Gwet’s AC1. The frequencies of AEs were tallied and reported as counts and percentages.

Results

The most common AEs identified in the videos were failure to measure temperature (86.7%) and inadequate personal protective equipment (86.7%), followed by inability to use closed-loop communication (76.7%). The agreement on all AEs between reviewers was 0.94 (95% CI: 0.93–0.95). The Gwet’s AC1 agreement across the 9 AE categories was paramedic handover (0.82), airway and breathing (0.99), circulation (0.95), assessment of injuries (0.91), management of injuries (0.96), procedure-related (0.97), patient monitoring and IV access (0.99), disposition (0.98), team communication and dynamics (0.87).

Conclusion

The STAT taxonomy demonstrated excellent inter-rater reliability between reviewers and can be used to identify AEs in video-recorded trauma resuscitations. These results provide a foundation for adapting video review to objectively quantify and assess AEs in the trauma bay.

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Data availability

A de-identified dataset associated with the paper is available upon reasonable request.

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Acknowledgements

We would like to thank Physician Services Incorporated and the St. Michael’s Hospital Association Alternate Funds Plan for their financial support for this study.

Funding

BN is supported by Physician Services Incorporated and the St. Michael’s Hospital Association Alternate Funds Plan. The funders did not have a role in study design, data analysis, interpretation of the results, writing the manuscript, or submitting the article for publication.

Author information

Authors and Affiliations

  1. Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada

    Anisa Nazir

  2. Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada

    Anisa Nazir, Melissa McGowan & Brodie Nolan

  3. Emergency Medicine, USF/HCA Oak Hill Hospital, Brooksville, Florida, USA

    Nemanja Baletic

  4. Department of Surgery, Division of Burn, Trauma, Acute and Critical Care Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Ryan P. Dumas & Caitlin Fitzgerald

  5. Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada

    Keying Xu

  6. Division of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada

    Brodie Nolan

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  7. Brodie Nolan
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Contributions

BN, NB, CF, and RD conceived and designed the study. BN and MM obtained research ethics approval. NB, CF, RD, and BN performed data collection. AN and KX analyzed the data. AN and BN drafted the manuscript, and all authors contributed substantially to its revision. BN takes responsibility for the paper as a whole.

Corresponding author

Correspondence to Anisa Nazir.

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Conflict of interest

AN, NB, CF, KX, MM, RD, and BN declare that they have no conflict of interest.

Ethical approval

Approval was obtained from the ethics committee of Unity Health Toronto (REB ID # 22-015).

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Supplementary file1 (DOCX 23 kb)

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Nazir, A., Baletic, N., Dumas, R.P. et al. Reliability of the safety threats and adverse events in trauma (STAT) taxonomy using trauma video review. Eur J Trauma Emerg Surg 50, 497–504 (2024). https://doi.org/10.1007/s00068-023-02381-y

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  • DOI: https://doi.org/10.1007/s00068-023-02381-y

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