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The Lack of Common Goals and Communication Within a Level I Trauma System

Assessing the Silo Effect Among Trauma Center Employees

Mace-Vadjunec, Daneen RN, MHHS, ONC; Hileman, Barbara M. BA; Melnykovich, M. Ben RN, BSAS; Hanes, Marina C. BA; Chance, Elisha A. BSAS; Emerick, Eric S. BA

doi: 10.1097/JTN.0000000000000153

We assessed our level I trauma center's employees' perception of inter- and intradepartmental relationships to determine whether employees who work less often with patients feel less involved—the silo effect. We prospectively evaluated employees who provide direct patient care using the Trauma System Survey tool. Of 1155 employees, 699 responded. Combined interdepartmental relationships showed that 93% believed their unit communicated well with other units, and 86% thought other units communicated well with their unit. However, 69% experienced miscommunication between units. To reduce silos, communication is key. Training and multiunit events may help reduce these silos further.

St Elizabeth Youngstown Hospital, Youngstown, Ohio (Mss Mace-Vadjunec, Hileman, Hanes, and Chance and Mr Melnykovich); and Youngstown State University, One University Plaza, Youngstown, Ohio (Mr Emerick).

Correspondence: Daneen Mace-Vadjunec, RN, MHHS, ONC, St Elizabeth Youngstown Hospital, 1044 Belmont Ave, Youngstown, OH 44501 (

No financial support was received for this study, and the authors declare no conflicts of interest.

Author Contributions: D.M.V., B.M.H., M.B.M., M.C.H., E.A.C., and E.S.E. made substantial contributions to the conception and design of the work; the acquisition, analysis, and interpretation of data for the work; drafting the work and revising it critically for important intellectual content; final approval of the version to be published; and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Copyright © 2015 by the Society of Trauma Nurses.