Throughput Analysis of Trauma Resuscitations with Financial Impact

• Published in: The Journal of Trauma: Injury, Infection, and Critical Care Vol. 42; no. 2; pp. 294 - 298
• Main Authors: Imami, Emran R., Clevenger, Frederick W., Lampard, Simon D., Kallenborn, Celeste, Tepas, Joseph J.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Baltimore, MD Williams & Wilkins 01-02-1997; Lippincott Williams & Wilkins
• Subjects: Adult; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Emergency and intensive care: techniques, logistics; Female; Florida; Health Care Rationing; Hospital Costs; Hospitals, University; Humans; Intensive care medicine; Intensive care unit. Emergency transport systems. Emergency, hospital ward; Male; Medical sciences; Middle Aged; Resuscitation - statistics & numerical data; Time Factors; Trauma Centers - economics; Trauma Centers - organization & administration; Triage; Wounds and Injuries - economics; Wounds and Injuries - therapy; Human; Health care staff; Physician; Hospital; Trauma; Resuscitation; Cost efficiency analysis
• ISSN: 0022-5282; 1529-8809
• DOI: 10.1097/00005373-199702000-00020

OBJECTIVES In an era of diminishing reimbursement, efficient resource utilization is paramount. The effects of three parallel factors were tracked(a) coordinated physician-hospital patient care, (b) increasing physician awareness of resources, and (c) in-house trauma attendings.
DESIGN Observational study.
METHODS A Windows-based database application was made to track all resuscitations at a Level I adult/pediatric trauma center. Time data were immediately entered upon discharge from the resuscitation bay, and further data (Injury Severity Score, length of stay, and mortality) were obtained by linking to a concurrent trauma registry. Group I was a 6-month control. Group II reflects factors a and b, and group III adds factor c, each contributing 3 months of additional data. Statistical comparisons were made using analysis of variance and Fisher's exact test.
RESULTS There were 2,546 resuscitations with 1,201, 636, and 709 in groups I, II, and III, respectively. The five most frequent dispositions, resuscitation times, and hospital costs were analyzed.
CONCLUSIONS Given similar patient groups, factors a and b together and factor c improved throughput in the resuscitation bay by approximately 35% (5-133 min) each. Hospital costs concurrently decreased with no rise in mortality.