RT Journal Article
SR Electronic
T1 Morning report decreases length of stay in trauma patients
JF Trauma Surgery & Acute Care Open
FD BMJ Publishing Group Ltd
SP e000185
DO 10.1136/tsaco-2018-000185
VO 3
IS 1
A1 John D Wolfe
A1 James R Gardner
A1 William C Beck
A1 John R Taylor
A1 Avi Bhavaraju
A1 Ben Davis
A1 Mary Katherine Kimbrough
A1 Ronald D Robertson
A1 Saleema A Karim
A1 Kevin W Sexton
YR 2018
UL http://tsaco.bmj.com/content/3/1/e000185.abstract
AB Background Modern 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.Methods The 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.14.2Results A 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.Discussion This 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 evidence Level 4, Care Management.