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Original research
Towards a more intelligent model of providing pediatric trauma care: identifying temporal variations in trauma team activations
  1. Arianne Johnson1,
  2. Rohit Sharma2,
  3. John Anis3,
  4. Stephen Kaminski2,
  5. Robert Kanard4
  1. 1Cottage Health Research Institute, Santa Barbara Cottage Hospital, Santa Barbara, California, USA
  2. 2Trauma, Santa Barbara Cottage Hospital, Santa Barbara, California, USA
  3. 3Emergency Medicine, Santa Barbara Cottage Hospital, Santa Barbara, California, USA
  4. 4Pediatric Surgery, Santa Barbara Cottage Hospital, Santa Barbara, California, USA
  1. Correspondence to Dr Arianne Johnson; a11johns{at}sbch.org

Abstract

Background Trauma centers are resource-intensive environments, and pediatric-specific personnel are often limited resources. Identifying the temporal patterns of pediatric traumas can help guide resource allocation strategies to optimize patient care.

Methods We conducted a retrospective, single-institution analysis of 575 injured patients less than 18 years old that triggered a trauma team activation (TTA). TTA volume according to time of day and day of the week was analyzed using a mixed Poisson regression model and monthly patterns were analyzed using an analysis of variance. Subset analyses were conducted for children and teenagers.

Results Across all days, the 6-hour time frame between 15:00 and 21:00 had significantly more activations than average, encompassing nearly half (47.2%) of all pediatric TTAs (p=0.01). Saturdays had significantly more activations than the daily average (Saturdays: 26.0/year, Other: 14.8/year, p<0.01). A pediatric TTA was 3.6 times more likely to occur between 15:00 and 21:00 on a Saturday than any other time. Volume of activation did not significantly differ by month (p=0.880).

Conclusion The volume of pediatric trauma activations varies significantly according to time of day and day of the week. These findings can direct or validate resource allocation strategies such as staffing physicians, nurses, and ancillary personnel according to TTA volume.

Type of study Retrospective cohort study.

Level of evidence Level III.

  • pediatrics
  • resource allocation
http://creativecommons.org/licenses/by-nc/4.0/

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, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/tsaco-2020-000448

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    Footnotes

    • Contributors Study design: AJ, RK, SK, RS. Literature search: AJ, RS. Data collection: AJ, RS. Data analysis: AJ, RS, SK, RK. Writing: RS, AJ, RK, SK, JA. Critical revision: AJ, RS, JA, SK, RK.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request.