Trauma Attending Physician Continuity: Does it Make a Difference?

Continuity of care is important in achieving optimal outcomes in trauma patients, but the optimal length of the trauma attending (TA) rotation is unknown. We hypothesize that longer TA rotations provide greater continuity, and therefore improve outcomes. We did a retrospective comparison of trauma p...

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Bibliographic Details
Published in:The American surgeon Vol. 76; no. 1; pp. 48 - 54
Main Authors: Jacobs, David G., Sarafin, Jennifer L., Head, Karen E., Christmas, A Britt, Huynh, Toan, Miles, William S., Sing, Ronald F.
Format: Journal Article
Language:English
Published: United States SAGE PUBLICATIONS, INC 01.01.2010
Subjects:
Adult
Continuity of Patient Care
Emergency medical care
Female
Hospitals
Humans
Length of Stay
Male
Medical Staff, Hospital - organization & administration
Morbidity
North Carolina
Personnel Staffing and Scheduling
Physicians
Retrospective Studies
Studies
Treatment Outcome
Wounds and Injuries - complications
Wounds and Injuries - therapy
North Carolina
ISSN:0003-1348, 1555-9823
Online Access:Get full text
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Summary:Continuity of care is important in achieving optimal outcomes in trauma patients, but the optimal length of the trauma attending (TA) rotation is unknown. We hypothesize that longer TA rotations provide greater continuity, and therefore improve outcomes. We did a retrospective comparison of trauma patient outcomes from two consecutive 6-month periods during which we transitioned from a 1-month TA rotation to a 1-week TA rotation. The Wilcoxon rank sum test, and the χ 2 were used for statistical analysis. Over the 12-month study period 1924 patients were admitted to the Trauma Service. The two groups were similar with regard to age, gender, injury mechanism, Injury Severity Score and Glasgow Coma Scale scores, and Abbreviated Injury Scores for the chest, abdomen, and extremities. Although mortality, patient charges, and violations of the standard of care were similar between the two groups, overall morbidity was lower (18.6% vs 23.2%), and hospital length of stay higher (9.07 days vs 8.41 days) in the 1-week TA group compared with the 1-month TA group. A one-week TA rotation was associated with a longer hospital length of stay, but improved morbidity. Longer TA rotations do not necessarily provide improved continuity or improved outcomes.
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ISSN:0003-1348
1555-9823
DOI:10.1177/000313481007600110