Association of Initiation of Statewide Pediatric Trauma Collaborative and Hospital Preventable Transfer Rates.

IF 2.4 2区医学 Q1 PEDIATRICS

Journal of pediatric surgery Pub Date : 2024-10-26 DOI:10.1016/j.jpedsurg.2024.162004

Jack H Scaife, Christopher E Clinker, Abigail J Alexander, Stephanie E Iantorno, R Scott Eldredge, Robert A Swendiman, Stephen J Fenton, Katie W Russell

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引用次数: 0

Abstract

Introduction: The Utah Pediatric Trauma Network (UPTN), established in 2019, is a collaboration of hospitals that have implemented guidelines to optimize pediatric trauma care. The purpose of this study was to determine whether preventable transfer (PT) rates decreased following the establishment of the UTPN and what hospital characteristics were associated with decreased preventable transfers.

Methods: Children with traumatic injuries transferred from hospitals in the UPTN to the state's only Level I Pediatric Trauma Center between 2013 and 2023 were retrospectively analyzed. A PT was a child discharged within 48 h of arrival without surgical intervention or advanced imaging studies. The main hospital-level outcome measure was an overall decrease in PT after the UPTN establishment in 2019.

Results: After 2019, 34 of the 46 hospitals meeting inclusion criteria saw a decrease in the percentage of PTs, while 12 saw an increase in PT rate, with an overall median change of -7 % (IQR -14 %, 0 %). We observed that hospitals with decreased PT had higher rates of PT before the establishment of the UPTN and had higher overall transfer volume than hospitals without a decreased PT rate. Can we put the overall p value in this?

Conclusion: Most hospitals were able to successfully decrease PT rates following the creation of the UPTN. More smaller hospitals did not successfully decrease PT, so more work may need to be done to target lower-volume hospitals.

查看原文本刊更多论文

全州儿科创伤协作组的启动与可预防的转院率之间的关系。

导言：犹他州儿科创伤网络（UTPN）成立于 2019 年，是一个由实施了优化儿科创伤护理指南的医院组成的合作组织。本研究旨在确定可预防性转院（PT）率在UTPN成立后是否有所下降，以及哪些医院特征与可预防性转院率下降有关：方法：研究人员对 2013 年至 2023 年间从 UTPN 医院转至该州唯一的一级儿科创伤中心的外伤患儿进行了回顾性分析。PT指的是在到达医院后48小时内出院，且未进行外科手术或高级影像学检查的儿童。医院层面的主要结果指标是，2019 年 UPTN 成立后，PT 的总体下降情况：2019年后，在符合纳入标准的46家医院中，34家医院的PT比例下降，12家医院的PT率上升，总体变化中位数为-7%（IQR为-14%，0%）。我们观察到，与 PT 率没有下降的医院相比，PT 率下降的医院在 UPTN 成立之前的 PT 率更高，而且总体转院量也更大。结论：大多数医院都能成功降低转运率：大多数医院都能在 UPTN 成立后成功降低 PT 率。更多规模较小的医院未能成功降低转运率，因此可能需要针对转运量较低的医院开展更多工作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of pediatric surgery 医学-外科

CiteScore

1.10

自引率

12.50%

发文量

569

审稿时长

38 days

期刊介绍： The journal presents original contributions as well as a complete international abstracts section and other special departments to provide the most current source of information and references in pediatric surgery. The journal is based on the need to improve the surgical care of infants and children, not only through advances in physiology, pathology and surgical techniques, but also by attention to the unique emotional and physical needs of the young patient.