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Towards a more intelligent model of providing pediatric trauma care: identifying temporal variations in trauma team
Arianne Johnson1, Rohit Sharma2, John Anis3
1Cottage Health Research Institute, Santa Barbara Cottage Hospital, Santa Barbara, California, USA.
Insights
Pediatric trauma team activations peak on Saturday afternoons and evenings. Understanding these temporal patterns helps optimize staffing and resource allocation in trauma centers for better pediatric patient care.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Surgery
- Healthcare Operations Management
Background:
- Trauma centers face resource limitations, particularly for pediatric-specific personnel.
- Optimizing care requires understanding temporal patterns of pediatric trauma cases.
Purpose of the Study:
- To analyze temporal patterns of pediatric trauma team activations (TTA).
- To inform resource allocation strategies in pediatric trauma care.
Main Methods:
- Retrospective cohort study of 575 pediatric patients (<18 years) requiring trauma team activation.
- Mixed Poisson regression analyzed TTA volume by time of day and day of week.
- Analysis of variance examined monthly patterns; subset analyses for children and teenagers.
Main Results:
- Pediatric TTAs significantly increased between 15:00 and 21:00 (47.2% of cases, p=0.01).
- Saturdays showed significantly higher activation volumes (26.0/year vs. 14.8/year, p<0.01).
- Peak risk (3.6x higher) occurred 15:00-21:00 on Saturdays; no significant monthly variation.
Conclusions:
- Pediatric trauma activation volume demonstrates significant diurnal and weekly variations.
- Findings support data-driven resource allocation, including staffing, to match TTA volume fluctuations.
Background:
Trauma centers are resource-intensive environments, and pediatric-specific personnel are often limited resources. Identifying the temporal patterns of pediatric traumas can help guide resource allocation strategies to optimize patient care.
Methods:
We conducted a retrospective, single-institution analysis of 575 injured patients less than 18 years old that triggered a trauma team activation (TTA). TTA volume according to time of day and day of the week was analyzed using a mixed Poisson regression model and monthly patterns were analyzed using an analysis of variance. Subset analyses were conducted for children and teenagers.
Results:
Across all days, the 6-hour time frame between 15:00 and 21:00 had significantly more activations than average, encompassing nearly half (47.2%) of all pediatric TTAs (p=0.01). Saturdays had significantly more activations than the daily average (Saturdays: 26.0/year, Other: 14.8/year, p<0.01). A pediatric TTA was 3.6 times more likely to occur between 15:00 and 21:00 on a Saturday than any other time. Volume of activation did not significantly differ by month (p=0.880).
Conclusion:
The volume of pediatric trauma activations varies significantly according to time of day and day of the week. These findings can direct or validate resource allocation strategies such as staffing physicians, nurses, and ancillary personnel according to TTA volume.
Type Of Study:
Retrospective cohort study.
Level Of Evidence:
Level III.
