Day for night: Should we staff a trauma center like a nightclub?

Carmody, I. C., Romero, J. and Velmahos, G. C. (2002). Day for night: Should we staff a trauma center like a nightclub?. In: Annual Meeting of the Southern California Chapter of the American-College-of-Surgeons, Santa Barbara California, (1048-1051). 18-20 January 2002.

Author Carmody, I. C.
Romero, J.
Velmahos, G. C.
Title of paper Day for night: Should we staff a trauma center like a nightclub?
Conference name Annual Meeting of the Southern California Chapter of the American-College-of-Surgeons
Conference location Santa Barbara California
Conference dates 18-20 January 2002
Journal name American Surgeon   Check publisher's open access policy
Place of Publication Cumming, GA, United States
Publisher Southeastern Surgical Congress
Publication Year 2002
Sub-type Fully published paper
ISSN 0003-1348
1555-9823
Volume 68
Issue 12
Start page 1048
End page 1051
Total pages 4
Language eng
Abstract/Summary Most trauma services throughout the country are staffed on a fixed-call rotational basis. Staff is deployed in a linear fashion when trauma often occurs in a skewed sporadic fashion resulting in large fluctuations in volume, injury severity, and mechanism of injury. Medical error and increased mortality have been associated with certain admission times. We reviewed 8015 consecutive major trauma admissions over a 3-year period. When reviewing aggregate data we found a significant difference in mortality between patients admitted during the day (7:00 AM to 6:59 PM) compared with those admitted at night (7:00 PM to 6:59 AM) (10.1% vs 13.1%, P < 0.01). On further analysis the two populations were found to be significantly different in volume, Injury Severity Score (ISS), and mechanism of injury. More patients were admitted at night and on weekends. They had a higher ISS, higher frequency of penetrating trauma, and a higher likelihood of undergoing operative intervention. Multiple subset analyses were performed stratifying for ISS, time of admission, day of admission, and mechanism of injury using mortality rate as the end point. Six comparisons were performed: 1) morning versus night admission; 2) weekday versus weekend admission; 3) least busy day (Tuesday) versus busiest day (Sunday) admission; 4) weeknight versus weekend night admission; 5) in cases of penetrating trauma, morning versus night admission; and 6) in cases of blunt trauma, morning versus night admission. None of the six comparisons showed a significant difference in mortality. There was no significant difference in ISS-matched mortality related to fixed trauma call staffing.
Keyword New-York-State
Surgical Residents
Performance
Care
Mortality
Q-Index Code E1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Conference Paper
Collection: School of Medicine Publications
 
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