scholarly journals Are trauma research programs in academic and non-academic centers measured by equal standards? A survey of 137 level I trauma centers in the United States

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Robert M. Madayag ◽  
Erica Sercy ◽  
Gina M. Berg ◽  
Kaysie L. Banton ◽  
Matthew Carrick ◽  
...  
Keyword(s):  
General Surgery ◽  
Trauma Surgery ◽  
The United States ◽  
Full Time ◽  
Trauma Centers ◽  
Patient Volume ◽  
Non Profit ◽  
Trauma Research ◽  
Research Programs ◽  
Level I

Abstract Background American College of Surgeons level I trauma center verification requires an active research program. This study investigated differences in the research programs of academic and non-academic trauma centers. Methods A 28-question survey was administered to ACS-verified level I trauma centers in 11/12/2020–1/7/2021. The survey included questions on center characteristics (patient volume, staff size), peer-reviewed publications, staff and resources dedicated to research, and funding sources. Results The survey had a 31% response rate: 137 invitations were successfully delivered via email, and 42 centers completed at least part of the survey. Responding level I trauma centers included 36 (86%) self-identified academic and 6 (14%) self-identified non-academic centers. Academic and non-academic centers reported similar annual trauma patient volume (2190 vs. 2450), number of beds (545 vs. 440), and years of ACS verification (20 vs. 14), respectively. Academic centers had more full-time trauma surgeons (median 8 vs 6 for non-academic centers) and general surgery residents (median 30 vs 7) than non-academic centers. Non-academic centers more frequently ranked trauma surgery (100% vs. 36% academic), basic science (50% vs. 6% academic), neurosurgery (50% vs. 14% academic), and nursing (33% vs. 0% academic) in the top three types of studies conducted. Academic centers were more likely to report non-profit status (86% academic, 50% non-academic) and utilized research funding from external governmental or non-profit grants more often (76% vs 17%). Conclusions Survey results suggest that academic centers may have more physician, resident, and financial resources available to dedicate to trauma research, which may make fulfillment of ACS level I research requirements easier. Structural and institutional changes at non-academic centers, such as expansion of general surgery resident programs and increased pursuit of external grant funding, may help ensure that academic and non-academic sites are equally equipped to fulfill ACS research criteria.

Assessment of Psychiatric Symptoms at a Level I Trauma Center Surgery Follow-up Clinic: A Preliminary Report

2013 ◽  
Vol 79 (5) ◽  
pp. 492-494 ◽  
Author(s):  
Erich J. Conrad ◽  
Tonya C. Hansel ◽  
Nicholas G. Pejic ◽  
Joseph Constans
Keyword(s):  
Community Violence ◽  
Psychiatric Symptoms ◽  
Trauma Surgery ◽  
Trauma Centers ◽  
Psychiatric Consultation ◽  
Surgical Services ◽  
Patient Health ◽  
Disorder Identification ◽  
Level I

At Level I trauma centers, psychiatric consultation is readily available to inpatient surgical services. This study sought to characterize the psychiatric symptoms present in the surgical follow-up clinic. Patients aged 18 years and older were assessed over one month for symptoms of posttraumatic stress disorder (PTSD) with the Short PTSD Rating Interview (SPRINT), depression with the Patient Health Questionnaire (PHQ-9), alcohol abuse with the Alcohol Use Disorder Identification Test (AUDIT), and the presence of violence using the MacArthur Community Violence Instrument (MCVIa [victimization] MCVIb [perpetration]). Twenty-five individuals participated. Using the SPRINT, 13 (52.0%) met the cutoff for PTSD. For PHQ-9 depression, 11 (44%) were in the moderate to severe range. For AUDIT, five (20.0%) likely had an alcohol problem. Using the MCVI, 15 (60.0%) reported victimization and 12 (48.0%) reported perpetration. Elevated levels of psychiatric symptoms were found in the trauma surgery follow-up clinic. Psychiatric care embedded in this setting may be warranted.

Wiser with Age? Increased Per-Surgeon Elderly Patient Volume is Associated with Lower Postinjury Complications

2018 ◽  
Vol 84 (6) ◽  
pp. 1027-1032 ◽  
Author(s):  
Elizabeth Warnack ◽  
Joshua Simon ◽  
Quoc Dang ◽  
Joseph Catino ◽  
Marko Bukur
Keyword(s):  
Elderly Patient ◽  
Elderly Patients ◽  
Hospital Mortality ◽  
Trauma Surgery ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Patient Volume ◽  
Clinical Complications ◽  
Volume Group ◽  
Level I

We hypothesize that higher elderly patient volume per trauma surgeon is associated with fewer clinical complications. This is a retrospective cohort study which included elderly patients admitted to trauma surgery service within a five-year period, from 2009 to 2013, at two Level I trauma centers in Florida. Trauma surgeons were stratified into three groups depending on patient volume. Primary outcomes were postinjury complications and in-hospital mortality, and secondary outcomes were hospital length of stay (LOS), intensive care unit LOS, and ventilator days. A total of 2379 elderly patients were included in this study. Elderly patient volume per surgeon did not significantly differ based on years in practice after fellowship (P = 0.88). The higher volume group had lower incidence of complications (15% complication rate, P = 0.02), compared with the average and low-volume group (18.1 and 21%, respectively), and had significantly lower rates of acute respiratory failure (P = 0.04) and acute renal failure (P = 0.004). In-hospital mortality was not affected by volume. Hospital LOS was decreased in the higher volume group (mean LOS 7.4 days, P < 0.001). There appears to be a relationship between elderly patient volume and outcome, independent of surgeon years of experience.

scholarly journals Potential synergy between advanced primary stroke centers and level I or II trauma centers in the United States

2012 ◽  
Vol 30 (8) ◽  
pp. 1535-1539
Author(s):  
Asif A. Khan ◽  
Saqib A. Chaudhry ◽  
Ameer E. Hassan ◽  
Gustavo J. Rodriguez ◽  
M. Fareed K. Suri ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Trauma Centers ◽  
Potential Synergy ◽  
Level I

scholarly journals Effects of the first lockdown of the COVID-19 pandemic on the trauma surgery clinic of a German Level I Trauma Center

2021 ◽  
Author(s):  
Dirk Wähnert ◽  
Christian Colcuc ◽  
Georg Beyer ◽  
Markus Kache ◽  
Adrian Komadinic ◽  
...  
Keyword(s):  
Trauma Center ◽  
Operating Time ◽  
Trauma Surgery ◽  
Working Hours ◽  
Intermediate Care ◽  
Trauma Centers ◽  
Level I ◽  
Hospital Days ◽  
Second Wave ◽  
Pandemic Wave

Abstract Purpose The effects of the first pandemic wave on a German Level I Trauma Center should be evaluated to find ways to redistribute structural, personnel, and financial resources in a targeted manner in preparation for the assumed second pandemic wave. Methods We examined the repercussions of the first wave of the pandemic on the trauma surgery clinic of a Level I Trauma Center and compared the data with data from 58 other trauma clinics. The results could aid in orientating the distribution of structural, financial, and human resources (HR) during the second wave. The period between March 16 and April 30, 2020 was compared with the data over the same period during 2019. Information was collected from the HR department, central revenue management, and internal documentation. Results The proportion of trauma surgical patients in the emergency room decreased by 22%. The number of polytrauma cases increased by 53%. Hospital days of trauma surgery patients in the intensive and intermediate care wards increased by 90%. The number of operations decreased by 15%, although the operating time outside of normal working hours increased by 44%. Clinics with more than 600 beds recorded a decrease in cases and emergencies by 8 and 9%, respectively, while the Trauma Center showed an increase of 19 and 12%. The results reflect the importance of level I trauma centers in the lockdown phase. Conclusion To reduce the risk of an increased burden on the healthcare infrastructure, it suggests the care of trauma and COVID-19 patients should be separated locally, when possible.

scholarly journals ECONOMIC CONTEXT OF VOLUNTEERING AND LABOUR MARKET IN SPORT

Ekonomika ◽  
2014 ◽  
Vol 93 (2) ◽  
pp. 116-130
Author(s):  
Eva Caslavova ◽  
Jiri Kraft ◽  
Josef Voracek ◽  
Monika Bartova
Keyword(s):  
Economic Value ◽  
The United States ◽  
Point Of View ◽  
Young Generation ◽  
Full Time ◽  
Federal Republic Of Germany ◽  
Non Profit ◽  
American Students ◽  
The Usa ◽  
Sport Clubs

Abstract. Volunteering for society is of multidimensional significance nowadays. From the organisation’s position, it represents a cheap source of work, mostly in the fields where there are several reasons for the work not being done by professionals, or possibly where it saves time for the employees who can more intensively perform other activities. It is of economical significance not only in the calculation of costs and expenses in the non-profit organizations’ management, but also on the macro-economical level. Therefore, several countries perform conversions of volunteering into full-time jobs, possibly into the economic value of volunteering in the respective country’s GDP creation. The problem probably lies in the fact that the acquired data depend more on the volunteering evaluation and are hardly comparable among the respective countries.From the marketing point of view, the other significance is found in creating goodwill and its spread by the organizations dealing with volunteering that can be used in systematic work with the media, in acquiring new volunteers, and in creating new types of stimuli for them.This research deals with the commitment and motivations of the young generation of Czech students of the Faculty of Physical Education and Sport of the Charles University in Prague (further FTVS UK) and of the following foreign universities and independent graduate schools: West Virginia State University (further WVSU) in the United States of America, and Deutsche Sporthochschule Köln (further DSHS) in the Federal Republic of Germany. The acquired results show that Czech students engage in volunteering very little in comparison with the foreign ones. Czech students have even stated that they do not have sufficient motivation for volunteering. If they engage, then it is mainly in the field of sports, which is quite understandable in the case of students of sports branches of study. Actually, over 85% of FTVS UK students only volunteer in the sports domains occasionally or very seldom, and they usually do it at sport events. At the same time, foreign German and U.S. students volunteer in sport clubs as a regular activity, also more students volunteer than in the Czech Republic. From the institutional point of view, sport clubs appear to be the most important promoter of volunteering in all of the mentioned countries.For students of the studied universities, the main reason for becoming a volunteer is “to acquire new experiences”. Another reason is the fact that they want to “support a good idea / project”. The research has shown that American students consider volunteering to be a moral obligation. In fact, volunteering in their society is a completely ordinary thing which makes citizens to be proud. For American students, to be serviceable to other people is the most important factor. This can be justified by the fact that volunteering is so popular in the USA because it is accepted as an ordinary part of life. On the contrary, German students prefer the fun standpoint connected with volunteering when performing volunteering. At the same time, Czech students give priority to an interesting environment to volunteer in. In general, regarding the respondents’ motivations we can state that students of these three universities evaluate volunteering as being a very good experience for them, and they mostly want to keep on doing it. However, this motivation was lower for the FTVS UK students in absence of any reward for their work. This implies that the Czech students perceive the essence of volunteering differently from foreign students.Key words: volunteering, volunteering in sport, benefits of volunteering for NGOs in sport, volunteers’ motivations, stimuli and motivating factors for volunteering

scholarly journals A Survey of Residency Directors in Academic Trauma Centers for Policies on Airway Management in The Trauma Ward

2021 ◽  
Author(s):  
George Tewfik ◽  
Michal Gajewski ◽  
Jena Salem ◽  
Neil Borad ◽  
Michael Zales ◽  
...  
Keyword(s):  
Emergency Medicine ◽  
Airway Management ◽  
Difficult Airway ◽  
Improve Patient Care ◽  
The United States ◽  
Trauma Centers ◽  
Difficult Airways ◽  
Level I ◽  
Trauma Activation ◽  
Trauma Bay

Abstract Background Despite its presence as a critical procedure in the trauma setting, airway management is not performed uniformly, varying between institutions, particularly with personnel involved in decision-making. Past literature has noted a trend in which emergency medicine physicians assumed greater responsibility for primary management of airways in the trauma ward. In addition, many institutions have adopted tiered activation systems for traumas in order to improve patient care, deploying resources more effectively. In this study, a survey of residency directors was deployed to assess trends in airway management. Methods A validated survey was distributed to residency directors in anesthesiology, general surgery and emergency medicine in 190 Level I trauma centers in the United States. Questions assessed personnel management, complication tracking and difficult airway prediction factors, amongst other considerations for airway management in the trauma bay. Results Respondents completed the survey at a rate of 23.8% of those solicited. A majority of respondents indicated that emergency medicine physicians are primary airway managers in the trauma bay and that their institutions utilize tiered trauma activation systems at 77.4% and 95.6% respectively. Anesthesia providers were immediately available in 81% of respondent institutions with inconclusive data regarding protocols for delineating anesthesia involvement in difficult airways. More than a third of respondents indicated their institution either does not track airway complications or they did not know if complications were tracked. Finally, nine different criteria were used in varying degrees by respondents’ institutions to predict the presence of a difficult airway, including such factors as head/face trauma, airway fluid and obesity. Conclusion The trend towards airway management by emergency medicine physicians in the trauma bay continues, with anesthesia personnel available in many situations to assist in complicated patients. Complication tracking for airway management remains inconsistent, as does the criteria for prediction of the presence of difficult airways.

Hospital Characteristics Affect Consent and Conversion Rates for Potential Organ Donors

2017 ◽  
Vol 83 (4) ◽  
pp. 354-358
Author(s):  
Jawad T. Ali ◽  
Aileen Ebadat ◽  
Danilo Martins ◽  
Sadia Ali ◽  
Shannon Horton ◽  
...  
Keyword(s):  
Organ Procurement ◽  
The United States ◽  
Organ Donors ◽  
Trauma Centers ◽  
Organ Procurement Organization ◽  
Academic Hospitals ◽  
Conversion Rates ◽  
Level I ◽  
Number Of Individuals ◽  
Hospital Characteristics

Consent and conversion rates of potential organ donors in the United States need to be maximized to match the number of individuals awaiting organ donation. Studies to date have not focused on characteristics of centers with better outcomes. We performed an 8-year (2006–2014) retrospective study of our local organ procurement organization database. We categorized hospitals in our region as academic centers versus nonacademic centers, trauma centers versus nontrauma centers, and large (≥400 beds) centers versus small (<400 beds) centers. We also compared trauma centers with Level I designation to all other centers. Primary outcomes included consent and conversion rates for potential organ donors. There were 22,732 referrals to our organ procurement organization that resulted in 1,057 eligible deaths. When comparing academic to nonacademic hospitals, academic hospitals had higher consent (71% vs 59%, P < 0.0001) and conversion (73% vs 64%, P = 0.008) rates. Level I trauma centers had better consent and conversion rates when compared to all other hospitals, 73 versus 55 per cent and 76 versus 61 per cent respectively, P < 0.0001 for both. The small, academic, trauma centers had the highest consent and conversion rates, 77 and 78 per cent, respectively, P < 0.0001 for both. Hospital characteristics such as academic involvement, Level I trauma designation, and size impact consent and conversion rates for potential organ donors. Small (<400 bed), academic, trauma centers have the highest consent rates and conversion rates. Factors for success in these institutions should be examined and applied to assist in improving donor rates across all types of hospitals.

scholarly journals An Overview of Trauma Center Levels and Disparities in Rural Trauma Care

2020 ◽  
Vol 10 ◽  
Author(s):  
Udit Dave ◽  
Brandon Gosine ◽  
Ashwin Palaniappan
Keyword(s):  
United States ◽  
Trauma Care ◽  
Rural Areas ◽  
The United States ◽  
Trauma Centers ◽  
Traumatic Injuries ◽  
Level Ii ◽  
Level I ◽  
Injured Patients

Trauma centers in the United States focus on providing care to patients who have suffered injuries and may require critical care. These trauma centers are classified into five different levels: Level I to Level V. Level V trauma centers are the least comprehensive, providing minimal 24-hour care and resuscitation, and Level I trauma centers are the most comprehensive, accepting the most severely injured patients and always delivering care through the use of an attending surgeon. However, there is a major inequity in access to trauma centers across the United States, especially amongst rural residents. Level III to Level V trauma centers tend to be dominantly situated in rural and underserved areas. Furthermore, trauma centers tend to be widely dispersed with respect to rural areas. Therefore, these areas tend to have a greater mortality rate in relation to traumatic injuries. Improvements in access to high-tier traumatic care must occur in order to reduce mortality due to traumatic injuries in underserved rural areas. Possible improvements to rural trauma care include bolstering the quality of care in Level III trauma centers, increasing Level II center efficiency through the involvement of orthopedic traumatologists, placing medical helicopter bases in more strategic locations that enable transport teams to reach other trauma centers faster, building more Level I and Level II trauma centers, and converting Level III centers into either Level I or Level II centers. 

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