Trauma Institutional Priorities and Teams for Outcome Efficacy (TIPTOE)

PROJECT SUMMARY/ABSTRACT
In the United States, trauma is the leading cause of death for individuals under the age of 45 and was
responsible for $671 billion in economic damage in 2013. Despite growing standardization of clinical trauma
care, at Level I and Level II trauma centers, there remains significant variability in patient outcomes across
trauma centers on both levels. To resolve this issue, two knowledge gaps will be addressed: a) which
organizational features impact patient outcomes and b) which organizational features are indicative of
institutional commitment. Our global hypothesis is that variability of organizational features in Level I and Level
II trauma centers is a significant factor in the variability of patient outcomes across those trauma centers. We will
also collect data on which organizational features are indicative of institutional commitment from the perspective
of trauma experts.
In Aim 1 we will collect data about the organizational characteristics and patient outcomes at 230 Level I
and Level 2 trauma centers. These centers will also provide us with their Trauma Quality Improvement Program
data, which includes patient outcomes. To support our global hypothesis, we will use these data to test whether
organizational features of the trauma centers show an impact on patient outcomes, specifically patient mortality,
length of stay, and risk-adjusted major complications.
In Aim 2 we will use the data about organizational characteristics to assess which organizational features
of trauma centers are indicative of institutional commitment using Latent Class analysis. This will allow us to
represent the dependencies between organizational features and institutional commitment and add this
information to the TIPTOE database. We will use these data to create automatic inferences on patterns of
institutional commitment to represent, group and analyze factors indicative of institutional commitment using data
collected in the present project. This provides an additional source of knowledge guiding trauma center planning
and decision-making.
In Aim 3 we will extend the Ontology of Organizational Structures of Trauma Centers and Trauma
Systems (OOSTT) to include institutional commitment and patient outcomes. We will set up the TIPTOE
Knowledge Base and create the Knowledge Path tool for users to explore, analyze, and visualize TIPTOE data.
We will test the hypothesis that the TIPTOE Knowledge Path is perceived to make a positive impact on
knowledge discovery and decision making in the user community.
This project will initialize a novel resource of patient outcome information for the trauma care community.
The purpose of this project is the next evolution of trauma center quality improvement allowing change based
on scientific evidence of which components of trauma centers affect patient outcomes.

Grant Number: 5R01GM111324-10
NIH Institute/Center: NIH
Principal Investigator: Mathias Brochhausen