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The Effect of Team Census on Outcomes in Trauma Patients
Anthony J Duncan1, David R Velez1, Khaled Zreik2,1
1Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Fargo, USA.
Background:
Physician workload has steadily increased, with higher workloads linked to worse patient outcomes. However, the impact of workload on trauma care remains unexplored. This study aims to evaluate the impact of the census on trauma patients' outcomes.
Methods:
We conducted a five-year retrospective analysis of all trauma patients admitted to our Level I trauma center. A multivariate regression analysis was performed to assess the relationship between team census on the day of admission and patient outcomes, adjusting for Injury Severity Score (ISS).
Results:
Patients admitted on high census days had significantly higher ISS. After adjusting for ISS, these patients demonstrated significantly higher rates of delirium but no significant differences in other complications. Notably, hospital length of stay was significantly shorter for patients admitted on high census days.
Conclusion:
The most severely injured trauma patients often present on the busiest days, potentially straining clinical resources. Higher delirium rates and shorter lengths of stay raise concerns about whether these patients receive optimal care or are being discharged prematurely. These findings underscore the critical need to preserve care quality during high-volume periods and to develop strategies that mitigate the impact of rising workloads on trauma patient outcomes.
