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Related Experiment Videos

In-house trauma attendings: is there a difference?

Rodney Durham1, David Shapiro, Lewis Flint

  • 1Department of Surgery, University of South Florida, Tampa General Hospital, 2 Columbia Drive, Suite G417, Tampa, FL 33606, USA. rdurham@hsc.usf.edu

American Journal of Surgery
|November 26, 2005
PubMed
Summary

Implementing in-house attending surgeons significantly reduced preventable trauma deaths. This change improved patient care outcomes without affecting overall mortality or length of stay.

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Area of Science:

  • Trauma Surgery
  • Surgical Outcomes
  • Healthcare Quality Improvement

Background:

  • Trauma patient outcomes were assessed before and after introducing in-house attending surgeon call.
  • The study compared a period with out-of-house (OH) call to a subsequent period with in-house (IH) call.

Purpose of the Study:

  • To evaluate the impact of in-house attending surgeons on trauma patient outcomes.
  • To determine if implementing an in-house call system reduces preventable deaths.

Main Methods:

  • A retrospective analysis of 2,019 trauma activations (1,036 OH, 983 IH).
  • Comparison of overall mortality, length of stay (LOS) in hospital, intensive care unit (ICU), and emergency department.
  • Analysis focused on the incidence of preventable deaths.

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Main Results:

  • No significant differences were observed in hospital LOS, ICU LOS, ventilator days, or overall mortality between OH and IH groups.
  • Preventable deaths decreased from 8.1% in the OH period to 1.0% in the IH period (P < .02).

Conclusions:

  • The implementation of an in-house attending surgeon call system led to a significant reduction in preventable trauma deaths.
  • Aggregate statistics may not fully capture the quality of care improvements achieved through dedicated in-house surgical presence.