Professionalism of Admitting and Consulting Services and Trauma Patient Outcomes. Issue 5 (17th May 2022)

• Record Type: Journal Article
• Authors: Cooper, William O.; Hickson, Gerald B.; Guillamondegui, Oscar D.; Cannon, Jeremy W; Charles, Anthony G.; Hoth, J. Jason; Alam, Hasan B.; Tillou, Areti; Luchette, Frederick A.; Skeete, Dionne A.; Domenico, Henry J.; Meredith, J. Wayne; Brennan, Theresa M. H.; Smith, Brian P; Kelz, Rachel R.; Biesterveld, Ben E.; Busuttil, Ashley; Jopling, Jeffrey K.; Hopkins, Joseph R.; Emory, Cynthia L.; Sullivan, Patricia G.; Martin, R. Shayn; Howerton, Russell M.; Cryer, Henry M.; Davidson, Heather A.; Gonzalez, Richard P.; Spain, David A.
• Is Part Of: Annals of surgery. Volume 275:Issue 5(2022)
• Page Start: 883
• Page End: 890
• Publication Date: 2022-05-17
• Subjects: complications -- professionalism -- teamwork -- trauma; Surgery -- Periodicals; 617.005
• DOI: 10.1097/SLA.0000000000005416
• Languages: English
• ISSNs: 0003-4932

Abstract

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 9 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 1 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, 9553 (13.4%) experienced the primary outcome of complications or death, including 1875 of 16, 107 patients (11.6%) with 0 high-risk services, 3788 of 28, 085 patients (13.5%) with 1 high-risk service, and 3890 of 26, 854 patients (14.5%) with 2+ highrisk services ( P < 0.001). In logistic regression models adjusting for relevant patient, injury, and site characteristics, patients who received care from 1 or more high-risk services were at 24.1% (95% confidence interval 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 1 service with a high proportion of physicians modeling unprofessional behavior were at an increased risk of death or complications.