Morning report decreases length of stay in trauma patients
BackgroundModern acute care surgery (ACS) programs depend on consistent patient hand-offs to facilitate care, as most programs have transitioned to shift-based coverage. We sought to determine the impact of implementing a morning report (MR) model on patient outcomes in the trauma service of a terti...
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Veröffentlicht in: | Trauma surgery & acute care open 2018-09, Vol.3 (1), p.e000185-e000185 |
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description | BackgroundModern acute care surgery (ACS) programs depend on consistent patient hand-offs to facilitate care, as most programs have transitioned to shift-based coverage. We sought to determine the impact of implementing a morning report (MR) model on patient outcomes in the trauma service of a tertiary care center.MethodsThe University of Arkansas for Medical Sciences (UAMS) Division of ACS implemented MR in October 2015, which consists of the trauma day team, the emergency general surgery day team, and a combined night float team. This study queried the UAMS Trauma Registry and the Arkansas Clinical Data Repository for all patients meeting the National Trauma Data Bank inclusion criteria from January 1, 2011 to April 30, 2018. Bivariate frequency statistics and generalized linear model were run using STATA V.14.2ResultsA total of 11 253 patients (pre-MR, n=6556; post-MR, n=4697) were analyzed in this study. The generalized linear model indicates that implementation of MR resulted in a significant decrease in length of stay (LOS) in trauma patients.DiscussionThis study describes an approach to improving patient outcomes in a trauma surgery service of a tertiary care center. The data show how an MR session can allow for patients to get out of the hospital faster; however, broader implications of these sessions have yet to be studied. Further work is needed to describe the decisions being made that allow for a decreased LOS, what dynamics exist between the attendings and the residents in these sessions, and if these sessions can show some of the same benefits in other surgical services.Level of evidenceLevel 4, Care Management. |
doi_str_mv | 10.1136/tsaco-2018-000185 |
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We sought to determine the impact of implementing a morning report (MR) model on patient outcomes in the trauma service of a tertiary care center.MethodsThe University of Arkansas for Medical Sciences (UAMS) Division of ACS implemented MR in October 2015, which consists of the trauma day team, the emergency general surgery day team, and a combined night float team. This study queried the UAMS Trauma Registry and the Arkansas Clinical Data Repository for all patients meeting the National Trauma Data Bank inclusion criteria from January 1, 2011 to April 30, 2018. Bivariate frequency statistics and generalized linear model were run using STATA V.14.2ResultsA total of 11 253 patients (pre-MR, n=6556; post-MR, n=4697) were analyzed in this study. The generalized linear model indicates that implementation of MR resulted in a significant decrease in length of stay (LOS) in trauma patients.DiscussionThis study describes an approach to improving patient outcomes in a trauma surgery service of a tertiary care center. The data show how an MR session can allow for patients to get out of the hospital faster; however, broader implications of these sessions have yet to be studied. Further work is needed to describe the decisions being made that allow for a decreased LOS, what dynamics exist between the attendings and the residents in these sessions, and if these sessions can show some of the same benefits in other surgical services.Level of evidenceLevel 4, Care Management.</description><identifier>ISSN: 2397-5776</identifier><identifier>EISSN: 2397-5776</identifier><identifier>DOI: 10.1136/tsaco-2018-000185</identifier><identifier>PMID: 30234164</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Age ; Clinical outcomes ; Communication ; Datasets ; Gender ; Generalized linear models ; Glasgow Coma Scale ; Hospitals ; Intensive care ; Length of stay ; Mortality ; Original ; Patients ; Quality control ; Regression analysis ; Surgery ; Teams ; Trauma ; Trauma care ; Variables ; Ventilators</subject><ispartof>Trauma surgery & acute care open, 2018-09, Vol.3 (1), p.e000185-e000185</ispartof><rights>Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2018 Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0 Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b3795-ab86bb397b9739eb7367659deea3043092f2c306ff8518ca530549ced69e8cc13</citedby><cites>FETCH-LOGICAL-b3795-ab86bb397b9739eb7367659deea3043092f2c306ff8518ca530549ced69e8cc13</cites><orcidid>0000-0002-1460-9867</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://tsaco.bmj.com/content/3/1/e000185.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://tsaco.bmj.com/content/3/1/e000185.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27549,27550,27924,27925,53791,53793,77601,77632</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30234164$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wolfe, John D</creatorcontrib><creatorcontrib>Gardner, James R</creatorcontrib><creatorcontrib>Beck, William C</creatorcontrib><creatorcontrib>Taylor, John R</creatorcontrib><creatorcontrib>Bhavaraju, Avi</creatorcontrib><creatorcontrib>Davis, Ben</creatorcontrib><creatorcontrib>Kimbrough, Mary Katherine</creatorcontrib><creatorcontrib>Robertson, Ronald D</creatorcontrib><creatorcontrib>Karim, Saleema A</creatorcontrib><creatorcontrib>Sexton, Kevin W</creatorcontrib><title>Morning report decreases length of stay in trauma patients</title><title>Trauma surgery & acute care open</title><addtitle>Trauma Surg Acute Care Open</addtitle><description>BackgroundModern acute care surgery (ACS) programs depend on consistent patient hand-offs to facilitate care, as most programs have transitioned to shift-based coverage. We sought to determine the impact of implementing a morning report (MR) model on patient outcomes in the trauma service of a tertiary care center.MethodsThe University of Arkansas for Medical Sciences (UAMS) Division of ACS implemented MR in October 2015, which consists of the trauma day team, the emergency general surgery day team, and a combined night float team. This study queried the UAMS Trauma Registry and the Arkansas Clinical Data Repository for all patients meeting the National Trauma Data Bank inclusion criteria from January 1, 2011 to April 30, 2018. Bivariate frequency statistics and generalized linear model were run using STATA V.14.2ResultsA total of 11 253 patients (pre-MR, n=6556; post-MR, n=4697) were analyzed in this study. The generalized linear model indicates that implementation of MR resulted in a significant decrease in length of stay (LOS) in trauma patients.DiscussionThis study describes an approach to improving patient outcomes in a trauma surgery service of a tertiary care center. The data show how an MR session can allow for patients to get out of the hospital faster; however, broader implications of these sessions have yet to be studied. Further work is needed to describe the decisions being made that allow for a decreased LOS, what dynamics exist between the attendings and the residents in these sessions, and if these sessions can show some of the same benefits in other surgical services.Level of evidenceLevel 4, Care Management.</description><subject>Age</subject><subject>Clinical outcomes</subject><subject>Communication</subject><subject>Datasets</subject><subject>Gender</subject><subject>Generalized linear models</subject><subject>Glasgow Coma Scale</subject><subject>Hospitals</subject><subject>Intensive care</subject><subject>Length of stay</subject><subject>Mortality</subject><subject>Original</subject><subject>Patients</subject><subject>Quality control</subject><subject>Regression analysis</subject><subject>Surgery</subject><subject>Teams</subject><subject>Trauma</subject><subject>Trauma care</subject><subject>Variables</subject><subject>Ventilators</subject><issn>2397-5776</issn><issn>2397-5776</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqNkU1LwzAYx4Mobsx9AC9S8OLBatI0SeNBkOEbTLzoOaTZ062jbWbSCvv2pm6O6ckcngTye_7Pyx-hU4KvCKH8uvXa2DjBJIsxDpEdoGFCpYiZEPxw7z1AY--XPSOYlBk9RgOKE5oSng7RzYt1TdnMIwcr69poBsaB9uCjCpp5u4hsEflWr6OyiVqnu1pHK92W0LT-BB0VuvIw3t4j9P5w_zZ5iqevj8-Tu2mcUyFZrPOM53loJpeCSsgF5YIzOQPQFKcUy6RIDMW8KDJGMqMZxSyVBmZcQmYMoSN0u9FddXkNMxNqO12plStr7dbK6lL9_mnKhZrbT8UJZWnKg8DFVsDZjw58q-rSG6gq3YDtvEpIOCnLRI-e_0GXtnNNGE8ljNGweEzSQJENZZz13kGxa4Zg1Zujvs1RvTlqY07IOdufYpfxY0UALjdAXi__ofcFWwqYqw</recordid><startdate>20180901</startdate><enddate>20180901</enddate><creator>Wolfe, John D</creator><creator>Gardner, James R</creator><creator>Beck, William C</creator><creator>Taylor, John R</creator><creator>Bhavaraju, Avi</creator><creator>Davis, Ben</creator><creator>Kimbrough, Mary Katherine</creator><creator>Robertson, Ronald D</creator><creator>Karim, Saleema A</creator><creator>Sexton, Kevin W</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1460-9867</orcidid></search><sort><creationdate>20180901</creationdate><title>Morning report decreases length of stay in trauma patients</title><author>Wolfe, John D ; Gardner, James R ; Beck, William C ; Taylor, John R ; Bhavaraju, Avi ; Davis, Ben ; Kimbrough, Mary Katherine ; Robertson, Ronald D ; Karim, Saleema A ; Sexton, Kevin W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b3795-ab86bb397b9739eb7367659deea3043092f2c306ff8518ca530549ced69e8cc13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Age</topic><topic>Clinical outcomes</topic><topic>Communication</topic><topic>Datasets</topic><topic>Gender</topic><topic>Generalized linear models</topic><topic>Glasgow Coma Scale</topic><topic>Hospitals</topic><topic>Intensive care</topic><topic>Length of stay</topic><topic>Mortality</topic><topic>Original</topic><topic>Patients</topic><topic>Quality control</topic><topic>Regression analysis</topic><topic>Surgery</topic><topic>Teams</topic><topic>Trauma</topic><topic>Trauma care</topic><topic>Variables</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wolfe, John D</creatorcontrib><creatorcontrib>Gardner, James R</creatorcontrib><creatorcontrib>Beck, William C</creatorcontrib><creatorcontrib>Taylor, John R</creatorcontrib><creatorcontrib>Bhavaraju, Avi</creatorcontrib><creatorcontrib>Davis, Ben</creatorcontrib><creatorcontrib>Kimbrough, Mary Katherine</creatorcontrib><creatorcontrib>Robertson, Ronald D</creatorcontrib><creatorcontrib>Karim, Saleema A</creatorcontrib><creatorcontrib>Sexton, Kevin W</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Trauma surgery & acute care open</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wolfe, John D</au><au>Gardner, James R</au><au>Beck, William C</au><au>Taylor, John R</au><au>Bhavaraju, Avi</au><au>Davis, Ben</au><au>Kimbrough, Mary Katherine</au><au>Robertson, Ronald D</au><au>Karim, Saleema A</au><au>Sexton, Kevin W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Morning report decreases length of stay in trauma patients</atitle><jtitle>Trauma surgery & acute care open</jtitle><addtitle>Trauma Surg Acute Care Open</addtitle><date>2018-09-01</date><risdate>2018</risdate><volume>3</volume><issue>1</issue><spage>e000185</spage><epage>e000185</epage><pages>e000185-e000185</pages><issn>2397-5776</issn><eissn>2397-5776</eissn><abstract>BackgroundModern acute care surgery (ACS) programs depend on consistent patient hand-offs to facilitate care, as most programs have transitioned to shift-based coverage. We sought to determine the impact of implementing a morning report (MR) model on patient outcomes in the trauma service of a tertiary care center.MethodsThe University of Arkansas for Medical Sciences (UAMS) Division of ACS implemented MR in October 2015, which consists of the trauma day team, the emergency general surgery day team, and a combined night float team. This study queried the UAMS Trauma Registry and the Arkansas Clinical Data Repository for all patients meeting the National Trauma Data Bank inclusion criteria from January 1, 2011 to April 30, 2018. Bivariate frequency statistics and generalized linear model were run using STATA V.14.2ResultsA total of 11 253 patients (pre-MR, n=6556; post-MR, n=4697) were analyzed in this study. The generalized linear model indicates that implementation of MR resulted in a significant decrease in length of stay (LOS) in trauma patients.DiscussionThis study describes an approach to improving patient outcomes in a trauma surgery service of a tertiary care center. The data show how an MR session can allow for patients to get out of the hospital faster; however, broader implications of these sessions have yet to be studied. Further work is needed to describe the decisions being made that allow for a decreased LOS, what dynamics exist between the attendings and the residents in these sessions, and if these sessions can show some of the same benefits in other surgical services.Level of evidenceLevel 4, Care Management.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>30234164</pmid><doi>10.1136/tsaco-2018-000185</doi><orcidid>https://orcid.org/0000-0002-1460-9867</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Age Clinical outcomes Communication Datasets Gender Generalized linear models Glasgow Coma Scale Hospitals Intensive care Length of stay Mortality Original Patients Quality control Regression analysis Surgery Teams Trauma Trauma care Variables Ventilators |
title | Morning report decreases length of stay in trauma patients |
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