Throughput analysis of trauma resuscitations with financial impact.
OBJECTIVE
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.


METHODS
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.
Imami
E R
ER
Department of Surgery, University of Florida Health Science Center/Jacksonville 32209-6511, USA.
Clevenger
F W
FW
Lampard
S D
SD
Kallenborn
C
C
Tepas
J J
JJ
D000328:Adult; D005260:Female; D005431:Florida; D015276:Health Care Rationing; D017721:Hospital Costs; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D012151:Resuscitation / Q000706:statistics & numerical data*; D013997:Time Factors; D014193:Trauma Centers / Q000191:economics / Q000458:organization & administration*; D014218:Triage; D014947:Wounds and Injuries / Q000191:economics / Q000628:therapy*