title: Surgeon commitment to trauma care decreases missed injuries.
abstract: 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.
authors.affiliation: Division of Traumatology, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Yen-Ko
authors.initials: YK
authors.lastname: Lin
authors.forename: Chia-Ju
authors.initials: CJ
authors.lastname: Lin
authors.forename: Hon-Man
authors.initials: HM
authors.lastname: Chan
authors.forename: Wei-Che
authors.initials: WC
authors.lastname: Lee
authors.forename: Chao-Wen
authors.initials: CW
authors.lastname: Chen
authors.forename: Hsing-Lin
authors.initials: HL
authors.lastname: Lin
authors.forename: Liang-Chi
authors.initials: LC
authors.lastname: Kuo
authors.forename: Yuan-Chia
authors.initials: YC
authors.lastname: Cheng
mesh_terms: D000328:Adult; D057210:Delayed Diagnosis / Q000517:prevention & control*; D003951:Diagnostic Errors / Q000517:prevention & control*; D004502:Education, Medical, Continuing; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011785:Quality Assurance, Health Care; D058996:Quality Improvement; D012189:Retrospective Studies; D066231:Surgeons / Q000193:education* / Q000592:standards; D013624:Taiwan / Q000453:epidemiology; D014193:Trauma Centers; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000601:surgery
keywords: Missed injuries; Patient safety; Trauma