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The Joint Theatre Clinical Case Conference (JTCCC): Clinical governance in action
  1. DJ Willdridge, Specialist Trainee in Anaesthesia1,
  2. Colonel TJ Hodgetts, CBE QHP, Defence Professor of Emergency Medicine,
  3. PF Mahoney, Defence Professor of Anaesthesia and Critical Care3 and
  4. L Jarvis, Assistant Chief of Defence Staff (Health)4
  1. 1City Hospital, Birmingham
  2. 3Royal Centre for Defence Medicine
  3. 4Surgeon General’s Department
  1. Birmingham Research Park, Vincent Drive, Birmingham B15 2SQ Prof.ADMEM{at}


Objectives To quantify the type and nature of the lessons and issues arising from the Joint Theatre Clinical Case Conference.

Methods An evaluation of all JTCCC minutes from inception on 30 Mar 07 to 05 Jun 08 (n=61) was performed in Jul 08. Each separate issue (n=207) was assigned a NATO ‘J’ category and further sub-divided into clinical and non-clinical issues. Detail of whether the issues were raised for information only, or required action to be taken was recorded, as was the outcome of this action.

Results A wide range of clinical and non-clinical issues (J1-J8), were identified. 23% (47) of the 207 issues were raised for information only. 77% (160) issues required action to be taken. 109 were closed within 3 weeks. 23 took more than 3 weeks to close. Eight weeks after the study period 28 issues were still being actively resolved. 85% of JTCCC teleconferences had full participation from both theatres. Technical difficulties and/or the treatment of casualties prevented the participation of one or both theatres on 9 occasions.

Conclusions JTCCC supports deployed clinicians and enables rapid resolution of issues affecting combat casualty care. It is limited by its focus on UK casualties only. Although intended as a Clinical Governance tool the evidence of this review is that JTCCC has wider effects in a number of clinical and non-clinical areas.

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