Professionalism of Admitting and Consulting Services and Trauma Patient Outcomes. Journal Article

Local Library Link: Find It @ Loyola

Authors: Cooper, WO; Hickson, GB; Guillamondegui, OD; Cannon, JW; Charles, AG; Hoth, JJ; Alam, HB; Tillou, A; Luchette, FA; Skeete, DA; Domenico, HJ; Meredith, JW; Brennan, TMH; Smith, BP; Kelz, RR; Biesterveld, BE; Busuttil, A; Jopling, JK; Hopkins, JR; Emory, CL; Sullivan, PG; Martin, RS; Howerton, RM; Cryer, HM; Davidson, HA; Gonzalez, RP; Spain, DA
Article Title: Professionalism of Admitting and Consulting Services and Trauma Patient Outcomes.
Abstract: OBJECTIVE: To determine whether trauma patients managed by an admitting or consulting service with a high proportion of physicians exhibiting patterns of unprofessional behaviors are at greater risk of complications or death. SUMMARY BACKGROUND DATA: Trauma care requires high-functioning interdisciplinary teams where professionalism, particularly modeling respect and communicating effectively, is essential. METHODS: This retrospective cohort study used data from nine level I trauma centers that participated in a national trauma registry linked with data from a national database of unsolicited patient complaints. The cohort included trauma patients admitted January 1, 2012 through December 31, 2017. The exposure of interest was care by one or more high-risk services, defined as teams with a greater proportion of physicians with high numbers of patient complaints. The study outcome was death or complications within 30?days. RESULTS: Among the 71,046 patients in the cohort, 9,553 (13.4%) experienced the primary outcome of complications or death, including 1,875 of 16,107 patients (11.6%) with 0 high-risk services, 3,788 of 28,085 patients (13.5%) with one high-risk service, and 3,890 of 26,854 patients (14.5%) with 2+ high-risk services (p?.001). In logistic regression models adjusting for relevant patient, injury, and site characteristics, patients who received care from one or more high-risk services were at 24.1% (95% CI 17.2% to 31.3%; P 0.001) greater risk of experiencing the primary study outcome. CONCLUSIONS: Trauma patients who received care from at least one service with a high proportion of physicians modeling unprofessional behavior were at an increased risk of death or complications.
Journal Title: Annals of Surgery
ISSN: 1528-1140; 0003-4932
Publisher: Unknown  
Date Published: 2022