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Impact of Starting an Emergency Medicine Residency Program on Overall Mortality Rate in a Regional Trauma Center

BACKGROUND: CHRISTUS Spohn Hospital Corpus Christi - Memorial began an Emergency Medicine Residency Program in March 2007. During each of the three years of their residency, residents are required to complete a trauma surgery rotation. These emergency medicine residents are the only residents partic...

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Autores principales: McLaughlin, Thomas, Blow, Osbert, Herrick, John, Richman, Peter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701062/
https://www.ncbi.nlm.nih.gov/pubmed/26767075
http://dx.doi.org/10.14740/jocmr2410w
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author McLaughlin, Thomas
Blow, Osbert
Herrick, John
Richman, Peter
author_facet McLaughlin, Thomas
Blow, Osbert
Herrick, John
Richman, Peter
author_sort McLaughlin, Thomas
collection PubMed
description BACKGROUND: CHRISTUS Spohn Hospital Corpus Christi - Memorial began an Emergency Medicine Residency Program in March 2007. During each of the three years of their residency, residents are required to complete a trauma surgery rotation. These emergency medicine residents are the only residents participating on this rotation as there is no surgical residency. The Department of Acute Care Surgery, Trauma and Surgical Critical Care analyzed the impact of the residents on trauma patient care outcomes with the hypothesis that there were no differences. METHODS: Data including length of stay in the hospital, length of stay in the intensive care unit, time spent in the emergency department (ED), morbidities and mortalities were compiled from the trauma registry for patients from the year before the residents began (March 1, 2006 to February 28, 2007) and compared with patients from the first year the residents began their trauma rotations (March 1, 2007 to February 29, 2008). T-tests and Mann-Whitney U tests were used to compare continuous variables and a Chi-square test was used to analyze the categorical variable (mortality). Linear and logistic regression analyses were also performed in order to adjust for potential confounding factors. RESULTS: Trauma patient admission rates were 1,316 before and 1,391 after the residents began. No statistically significant differences were found among all of the outcome variables during the two time periods except for time spent in the ED (P = 0.00), which increased during the year the residents began (236.83 ± 4.53 minutes in 2006 compared to 297.40 ± 5.55 minutes in 2007). Linear and logistic regression analyses confirmed these results with the exception of a statistically significant decrease in mortality with the residents on the trauma service (2.8% in 2006 and 2.1% in 2007, P = 0.00) after adjustment for multiple confounding factors. CONCLUSION: The addition of emergency medicine residents to the trauma care service did increase ED length of stay, but did not increase overall hospital or intensive care unit length of stay. There was a statistically significant decrease in adjusted morbidity and mortality, thus supporting our hypothesis that the residency program did not negatively impact the trauma service and its goals of high quality patient care.
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spelling pubmed-47010622016-01-13 Impact of Starting an Emergency Medicine Residency Program on Overall Mortality Rate in a Regional Trauma Center McLaughlin, Thomas Blow, Osbert Herrick, John Richman, Peter J Clin Med Res Original Article BACKGROUND: CHRISTUS Spohn Hospital Corpus Christi - Memorial began an Emergency Medicine Residency Program in March 2007. During each of the three years of their residency, residents are required to complete a trauma surgery rotation. These emergency medicine residents are the only residents participating on this rotation as there is no surgical residency. The Department of Acute Care Surgery, Trauma and Surgical Critical Care analyzed the impact of the residents on trauma patient care outcomes with the hypothesis that there were no differences. METHODS: Data including length of stay in the hospital, length of stay in the intensive care unit, time spent in the emergency department (ED), morbidities and mortalities were compiled from the trauma registry for patients from the year before the residents began (March 1, 2006 to February 28, 2007) and compared with patients from the first year the residents began their trauma rotations (March 1, 2007 to February 29, 2008). T-tests and Mann-Whitney U tests were used to compare continuous variables and a Chi-square test was used to analyze the categorical variable (mortality). Linear and logistic regression analyses were also performed in order to adjust for potential confounding factors. RESULTS: Trauma patient admission rates were 1,316 before and 1,391 after the residents began. No statistically significant differences were found among all of the outcome variables during the two time periods except for time spent in the ED (P = 0.00), which increased during the year the residents began (236.83 ± 4.53 minutes in 2006 compared to 297.40 ± 5.55 minutes in 2007). Linear and logistic regression analyses confirmed these results with the exception of a statistically significant decrease in mortality with the residents on the trauma service (2.8% in 2006 and 2.1% in 2007, P = 0.00) after adjustment for multiple confounding factors. CONCLUSION: The addition of emergency medicine residents to the trauma care service did increase ED length of stay, but did not increase overall hospital or intensive care unit length of stay. There was a statistically significant decrease in adjusted morbidity and mortality, thus supporting our hypothesis that the residency program did not negatively impact the trauma service and its goals of high quality patient care. Elmer Press 2016-02 2015-12-28 /pmc/articles/PMC4701062/ /pubmed/26767075 http://dx.doi.org/10.14740/jocmr2410w Text en Copyright 2016, McLaughlin et al. http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
McLaughlin, Thomas
Blow, Osbert
Herrick, John
Richman, Peter
Impact of Starting an Emergency Medicine Residency Program on Overall Mortality Rate in a Regional Trauma Center
title Impact of Starting an Emergency Medicine Residency Program on Overall Mortality Rate in a Regional Trauma Center
title_full Impact of Starting an Emergency Medicine Residency Program on Overall Mortality Rate in a Regional Trauma Center
title_fullStr Impact of Starting an Emergency Medicine Residency Program on Overall Mortality Rate in a Regional Trauma Center
title_full_unstemmed Impact of Starting an Emergency Medicine Residency Program on Overall Mortality Rate in a Regional Trauma Center
title_short Impact of Starting an Emergency Medicine Residency Program on Overall Mortality Rate in a Regional Trauma Center
title_sort impact of starting an emergency medicine residency program on overall mortality rate in a regional trauma center
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4701062/
https://www.ncbi.nlm.nih.gov/pubmed/26767075
http://dx.doi.org/10.14740/jocmr2410w
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