Surgeon commitment to trauma care decreases missed injuries

Injury. 2014 Jan;45(1):83-7. doi: 10.1016/j.injury.2012.10.019. Epub 2012 Nov 3.

Abstract

Study objective: Missed injuries sustain an important issue concerning patient safety and quality of care. The purpose of this study is to examine the effect of surgeon commitment to trauma care on missed injuries. We hypothesised that surgeons committed to the trauma service has less missed injuries than surgeons not committed to the trauma service would have.

Methods: By retrospective analysis of 976 adult patients admitted to the trauma intensive care unit (ICU) at an urban, university-based trauma centre. Missed injuries were compared between two groups; in group 1 the patients were evaluated and treated by the surgeons who were committed to the trauma service and in group 2 the patients were evaluated and treated by surgeons practicing mainly in other specialties.

Results: Patients had significantly lower rates of missed major or life-threatening injuries when treated by group 1 surgeons. Logistic regression model revealed significant factors associated with missed major or life-threatening injuries including ISS and groups in which patients were treated by different group surgeons.

Conclusions: Physicians will perform better when they are trained and interested in a specific area than those not trained, or even not having any particular interest in that specific area. Surgeons committed to the trauma service had less missed injuries in severely injured patients, and it is vital to improve patient safety and quality of care for trauma patients. Staff training and education for assessing severely injured patients and creating an open culture with detection and reduction of the potential for error are important and effective strategies in decreasing missed injuries and improving patient safety.

Keywords: Missed injuries; Patient safety; Trauma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Delayed Diagnosis / prevention & control*
  • Diagnostic Errors / prevention & control*
  • Education, Medical, Continuing*
  • Emergency Service, Hospital / standards*
  • Female
  • Humans
  • Injury Severity Score
  • Intensive Care Units
  • Length of Stay
  • Logistic Models
  • Male
  • Middle Aged
  • Quality Assurance, Health Care
  • Quality Improvement
  • Retrospective Studies
  • Surgeons / education*
  • Surgeons / standards
  • Taiwan / epidemiology
  • Trauma Centers*
  • Treatment Outcome
  • Wounds and Injuries / diagnosis*
  • Wounds and Injuries / surgery