@article {Nolane000805, author = {Brodie Nolan and Andrew Petrosoniak and Christopher M Hicks and Michael W Cripps and Ryan P Dumas}, title = {Defining adverse events during trauma resuscitation: a modified RAND Delphi study}, volume = {6}, number = {1}, elocation-id = {e000805}, year = {2021}, doi = {10.1136/tsaco-2021-000805}, publisher = {BMJ Specialist Journals}, abstract = {Background The majority of preventable adverse event (AEs) in trauma care occur during the initial phase of resuscitation, often within the trauma bay. However, there is significant heterogeneity in reporting these AEs that limits performance comparisons between hospitals and trauma systems. The objective of this study was to create a taxonomy of AEs that occur during trauma resuscitation and a corresponding classification system to assign a degree of harm.Methods This study used a modified RAND Delphi methodology to establish a taxonomy of AEs in trauma and a degree of harm classification system. A systematic review informed the preliminary list of AEs. An interdisciplinary panel of 22 trauma experts rated these AEs through two rounds of online surveys and a final consensus meeting. Consensus was defined as 80\% for each AE and the final checklist.Results The Delphi panel consisted of 22 multidisciplinary trauma experts. A list of 57 evidence-informed AEs was revised and expanded during the modified Delphi process into a finalized list of 67 AEs. Each AE was classified based on degree of harm on a scale from I (no harm) to V (death).Discussion This study developed a taxonomy of 67 AEs that occur during the initial phases of a trauma resuscitation with a corresponding degree of harm classification. This taxonomy serves to support a standardized evaluation of trauma care between centers and regions.Level of evidence Level 5.Data are available upon reasonable request. Data are available on reasonable request to the first author. Data consist only of deidentified participant data during the two stages of the Delphi procedure.}, URL = {http://tsaco.smart01.highwire.org/content/6/1/e000805}, eprint = {http://tsaco.smart01.highwire.org/content/6/1/e000805.full.pdf}, journal = {Trauma Surgery \& Acute Care Open} }