Skip to main content

Master of Public Health

Professionalism of Admitting and Consulting Services and Trauma Patient Outcomes

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 , . Annals of surgery. 2022 2 17; ().

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.

Tags: