title: Academic-community partnerships improve outcomes in pediatric trauma care.
abstract: BACKGROUND
  To address the specialized needs of injured children, pediatric trauma centers (PTCs) were established at many large, academic hospitals. This study explores clinical outcomes observed for injured children treated at an academic-sponsored community facility.
  
  
  METHODS
  In partnership with an academic medical center in a major metropolitan area, a not-for-profit community hospital became a designated Level II PTC in October 2010. Data for injured children <15 years old treated prior to PTC designation from January 2000 to September 2010 were prospectively collected using the Trauma and Emergency Medicine Information System and compared to data collected after PTC designation from January 2011 to December 2013.
  
  
  RESULTS
  Overall, 681 injured children were treated at the community hospital from January 2011 to December 2013. Children treated after PTC designation were less likely to undergo computed tomography (CT) (50.9% vs. 81.3%, p<0.01), even when controlling for age, gender, injury type, injury severity, and year (OR 0.18, 95%CI 0.08-0.37). Specifically, fewer head (45.7% vs. 68.7%, p<0.01) and abdominal CTs (13.2% vs. 26.5%, p<0.01) were performed. Hospital length of stay was significantly shorter (2.8 ± 3.7 days vs. 3.7 ± 5.9 days, p<0.01). Mortality was low overall, but also decreased after PTC designation (0.4% vs. 2.0%, p=0.02).
  
  
  CONCLUSIONS
  These results indicate that academic-community partnerships in pediatric trauma care are a feasible alternative and may lead to improved outcomes for injured children.
authors: Division of Pediatric Surgery, Department of Surgery, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, CHS Bldg., MC 957098, Los Angeles, CA, USA, 90095-7098; Robert Wood Johnson Foundation Clinical Scholars, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 10940 Wilshire Blvd. Ste 710, Los Angeles, CA, USA, 90095-7394. Electronic address: lkelley@mednet.ucla.edu.
authors: Lorraine I
authors: LI
authors: Kelley-Quon
authors: Trauma Department, Northridge Hospital Medical Center - Richie Pediatric Trauma Center, 18300 Roscoe Boulevard, Northridge, CA, USA, 91328. Electronic address: melanie.crowley@dignityhealth.org.
authors: Melanie A
authors: MA
authors: Crowley
authors: Division of Pediatric Surgery, Department of Surgery, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, CHS Bldg., MC 957098, Los Angeles, CA, USA, 90095-7098; Trauma Department, Northridge Hospital Medical Center - Richie Pediatric Trauma Center, 18300 Roscoe Boulevard, Northridge, CA, USA, 91328. Electronic address: happlebaum@mednet.ucla.edu.
authors: Harry
authors: H
authors: Applebaum
authors: Trauma Department, Northridge Hospital Medical Center - Richie Pediatric Trauma Center, 18300 Roscoe Boulevard, Northridge, CA, USA, 91328. Electronic address: katie.cummings@DignityHealth.org.
authors: Katie
authors: K
authors: Cummings
authors: Pediatrics Department, Northridge Hospital Medical Center - Richie Pediatric Trauma Center, 18300 Roscoe Boulevard, Northridge, CA, USA, 91328. Electronic address: Richard.Kang@DignityHealth.org.
authors: Richard J
authors: RJ
authors: Kang
authors: Robert Wood Johnson Foundation Clinical Scholars, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 10940 Wilshire Blvd. Ste 710, Los Angeles, CA, USA, 90095-7394. Electronic address: ctseng@mednet.ucla.edu.
authors: Chi-Hong
authors: CH
authors: Tseng
authors: Robert Wood Johnson Foundation Clinical Scholars, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 10940 Wilshire Blvd. Ste 710, Los Angeles, CA, USA, 90095-7394; David Geffen School of Medicine, University of California, Los Angeles, Jonathan and Karin Fielding School of Public Health, 10940 Wilshire Blvd Ste 700, Los Angeles, CA, USA, 90095-7394. Electronic address: cmangione@mednet.ucla.edu.
authors: Carol M
authors: CM
authors: Mangione
authors: Division of Pediatric Surgery, Department of Surgery, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, CHS Bldg., MC 957098, Los Angeles, CA, USA, 90095-7098; Trauma Department, Northridge Hospital Medical Center - Richie Pediatric Trauma Center, 18300 Roscoe Boulevard, Northridge, CA, USA, 91328. Electronic address: sshew@mednet.ucla.edu.
authors: Stephen B
authors: SB
authors: Shew
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D006764:Hospitals, Community; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017063:Outcome Assessment, Health Care; D010317:Partnership Practice / Q000458:organization & administration*; D012189:Retrospective Studies; D014193:Trauma Centers / Q000458:organization & administration*; D014481:United States; D014947:Wounds and Injuries / Q000628:therapy*
keywords: Community partnership; Pediatric trauma center