Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-26T02:44:11.219Z Has data issue: false hasContentIssue false
  • English
  • Français

Staffing in a Level 1 Trauma Center: Quantifying Capacity for Preparedness

Published online by Cambridge University Press:  15 September 2021

Kaitlin Woods ,
J.W. Awori Hayanga ,
Jeffrey Cannon ,
Wesley Lemons ,
Michael Philips ,
Ashley Schmidt ,
Roosevelt Boh ,
Kinza Noor ,
Lisa Fornaresio  and
Dylan Thibault
...Show all authors
Kaitlin Woods
Affiliation:
Department of Medical Education, West Virginia University, Morgantown, West Virginia, USA
J.W. Awori Hayanga
Affiliation:
Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia, USA
Jeffrey Cannon
Affiliation:
Department of Anesthesiology and Perioperative Medicine, Case Western Reserve University/University Hospitals, Cleveland, Ohio, USA
Wesley Lemons
Affiliation:
Department of Medical Education, West Virginia University, Morgantown, West Virginia, USA
Michael Philips
Affiliation:
Department of Internal Medicine and Emergency Medicine, Louisiana State University, New Orleans, Louisiana, USA
Ashley Schmidt
Affiliation:
Department of Pathology, Anatomy, and Laboratory Medicine, West Virginia University, Morgantown, West Virginia, USA
Roosevelt Boh
Affiliation:
Department of Medical Education, West Virginia University, Morgantown, West Virginia, USA
Kinza Noor
Affiliation:
Department of Medical Education, West Virginia University, Morgantown, West Virginia, USA
Lisa Fornaresio
Affiliation:
Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia, USA
Dylan Thibault
Affiliation:
Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, West Virginia, USA
PS Martin
Affiliation:
Department of Emergency Medicine, West Virginia University, Morgantown, West Virginia, USA
Alison Wilson
Affiliation:
Division of Trauma, Acute Care Surgery & Surgical Critical Care, Department of Surgery, West Virginia University, Morgantown, West Virginia, USA
Heather K. Hayanga*
Affiliation:
Division of Cardiovascular and Thoracic Anesthesiology, Department of Anesthesiology, West Virginia University, Morgantown, West Virginia, USA
*
Corresponding author: Heather Hayanga, Email: heather.hayanga@wvumedicine.org.
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

We sought to determine who is involved in the care of a trauma patient.

Methods:

We recorded hospital personnel involved in 24 adult Priority 1 trauma patient admissions for 12 h or until patient demise. Hospital personnel were delineated by professional background and role.

Results:

We cataloged 19 males and 5 females with a median age of 50-y-old (interquartile range [IQR], 35.5-67.5). The average number of hospital personnel involved was 79.71 (standard deviation, 17.62; standard error 3.6). A median of 51.2% (IQR, 43.4%-59.8%) of personnel were first involved within hour 1. More personnel were involved in direct versus indirect care (median 54.5 [IQR, 47.5-67.0] vs 25.0 [IQR, 22.0-30.5]; P < 0.0001). Median number of health-care professionals and auxiliary staff were 74.5 (IQR, 63.5-90.5) and 6.0 (IQR, 5.0-7.0), respectively. More personnel were first involved in hospital locations external to the emergency department (median, 53.0 [IQR, 41.5-63.0] vs 27.5 [IQR, 24.0-30.0]; P < 0.0001). No differences existed in total personnel by Injury Severity Score (P = 0.1266), day (P = 0.7270), or time of admission (P = 0.2098).

Conclusions:

A large number of hospital personnel with varying job responsibilities respond to severe trauma. These data may guide hospital staffing and disaster preparedness policies.

Keywords

decision-makingorganizationaldisaster planningmass casualty incidentspolicy-making
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 16 , Issue 5 , October 2022 , pp. 1990 - 1996
Copyright
© Society for Disaster Medicine and Public Health, Inc. 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Vaziri, K, Roland, JC, Robinson, L, et al. Optimizing physician staffing and resource allocation: sine-wave variation in hourly trauma admission volume. J Trauma. 2007;62(3):610-614. doi: 10.1097/TA.0b013e31803245c7 Google ScholarPubMed
Ogedegbe, C, Nyirenda, T, Delmoro, G, et al. Health care workers and disaster preparedness: barriers to and facilitators of willingness to respond. Int J Emerg Med. 2012;5(1):29. doi: 10.1186/1865-1380-5-29 CrossRefGoogle ScholarPubMed
Shartar, SE, Moore, BL, Wood, LM. Developing a mass casualty surge capacity protocol for emergency medical services to use for patient distribution. South Med J. 2017;110(12):792-795. doi: 10.14423/SMJ.0000000000000740 Google ScholarPubMed
Schenk, E, Wijetunge, G, Mann, NC, et al. Epidemiology of mass casualty incidents in the United States. Prehosp Emerg Care. 2014;18(3):408-416. doi: 10.3109/10903127.2014.882999 Google ScholarPubMed
Merrill, JA, Orr, M, Chen, DY, et al. Are we ready for mass fatality incidents? Preparedness of the US mass fatality infrastructure. Disaster Med Public Health Prep. 2016;10(1):87-97. doi: 10.1017/dmp.2015.135 Google ScholarPubMed
Dovgalyuk, J, Brady, WJ, Sidebottom, M, et al. The physician and mass medical event response: emergency preparedness implications. Am J Emerg Med. 2008;26(2):239-242. doi: 10.1016/j.ajem.2007.05.002 Google ScholarPubMed
Qureshi, K, Gershon, RRM, Sherman, MF, et al. Health care workers’ ability and willingness to report to duty during catastrophic disasters. J Urban Health. 2005;82(3):378-388. doi: 10.1093/jurban/jti086 CrossRefGoogle ScholarPubMed
Burke, RV, Goodhue, CJ, Chokshi, NK, et al. Factors associated with willingness to respond to a disaster: a study of healthcare workers in a tertiary setting. Prehosp Disaster Med. 2011;26(4):244-250. doi: 10.1017/S1049023X11006492 Google Scholar
Fattah, S, Krüger, AJ, Andersen, JE, et al. Major incident preparedness and on-site work among Norwegian rescue personnel - a cross-sectional study. Int J Emerg Med. 2012;5(1):40. doi: 10.1186/1865-1380-5-40 Google ScholarPubMed
Corrigan, E, Samrasinghe, I. Disaster preparedness in an Australian urban trauma center: staff knowledge and perceptions. Prehosp Disaster Med. 2012;27(12):432-438. doi: 10.1017/S1049023X12001045 CrossRefGoogle Scholar
Baker, MS. Creating order from chaos: part II: tactical planning for mass casualty and disaster response at definitive care facilities. Mil Med. 2007;172(3):237-243. doi: 10.7205/milmed.172.3.237 Google ScholarPubMed
Dal Ponte, ST, Dornelles, CFD, Arquilla, B, et al. Mass-casualty response to the Kiss Nightclub in Santa Maria, Brazil. Prehosp Disaster Med. 2015;30(1):93-96. doi: 10.1017/S1049023X14001368 CrossRefGoogle Scholar
Stevenson, M, Segui-Gomez, M, Lescohier, I, et al. An overview of the injury severity score and the new injury severity score. Inj Prev. 2001;7(1):10-13. doi: 10.1136/ip.7.1.10 Google ScholarPubMed
Michelson, KA, Stack, AM, Bachur, RG. Development of a model to measure emergency department staffing limitations. Pediatr Emerg Care. 2016;32(9):599-602. doi: 10.1097/PEC.0000000000000892 CrossRefGoogle Scholar
Tucker, JB, Barone, JE, Cecere, J, et al. Using queueing theory to determine operating room staffing needs. J Trauma. 1999;46(1):71-79. doi: 10.1097/00005373-199901000-00012 CrossRefGoogle ScholarPubMed
Gannon, CJ, Napolitano, LM, Pasquale, M, et al. A statewide population-based study of gender differences in trauma: validation of a prior single-institution study. J Am Coll Surg. 2002;195(1):11-18. doi: 10.1016/s1072-7515(02)01187-0 Google ScholarPubMed
Carmody, IC, Romero, J, Velmahos, GC. Day for night: should we staff a trauma center like a nightclub? Am Surg. 2002;68(12):1048-1051.Google Scholar
Carr, BG, Jenkins, P, Branas, CC, et al. Does the trauma system protect against the weekend effect? J Trauma. 2010;69(5):1042-1047. doi: 10.1097/TA.0b013e3181f6f958 Google ScholarPubMed
Arabi, Y, Alshimemeri, A, Taher, S. Weekend and weeknight admissions have the same outcome of weekday admissions to an intensive care unit with onsite intensivist coverage. Crit Care Med. 2006;34(3):605-611. doi: 10.1097/01.ccm.0000203947.60552.dd CrossRefGoogle Scholar
Egol, KA, Tolisano, AM, Spratt, KF, et al. Mortality rates following trauma: the difference is night and day. J Emerg Trauma Shock. 2011;4(2):178-183. doi: 10.4103/0974-2700.82202.Google ScholarPubMed
Magid, DJ, Wang, Y, Herrin, J, et al. Relationship between time of day, day of week, timeliness of reperfusion, and in-hospital mortality for patients with acute ST-segment elevation myocardial infarction. JAMA. 2005;294(7):803-812. doi: 10.1001/jama.294.7.803 CrossRefGoogle ScholarPubMed
Bauchner, H, Fontanarosa, PB, Livingston, EH. Conserving supply of personal protective equipment - a call for ideas. JAMA. 2020;323(19):1911. doi: 10.1001/jama.2020.4770.Google Scholar
World Health Organization (WHO). Rational use of personal protective equipment for coronavirus disease 2019 (COVID-19): interim guidance, 19 March 2020. WHO. 2020. https://apps.who.int/iris/handle/10665/331498. Accessed May 2020.Google Scholar
Ranney, ML, Griffeth, V, Jha, AK. Critical supply shortages - the need for ventilators and personal protective equipment during the Covid-19 pandemic. N Engl J Med. 2020;382(18):e41. doi: 10.1056/NEJMp2006141 Google ScholarPubMed