ArticleTrauma surgery & acute care open2017
Trauma advanced practice provider programme development in an academic setting to optimize care coordination.
Article in Trauma surgery & acute care open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Identifying the Surgical to Nonsurgical Care Transition for Trauma Patients: Time to Redesign Trauma Workflow.The American surgeon · 2026Article
- Integrating advanced practice providers in acute care surgery: considerations, solutions, and fresh perspectives.Trauma surgery & acute care open · 2026Article
- Intensive Care Unit Readmissions in a Level I Trauma Center.The Journal of surgical research · 2025Article
- Beyond capacity: an EAST multicenter mixed-methods study exploring surgeon perceptions on patient ratios in acute care surgery.Trauma surgery & acute care open · 2025Article
- [Advanced practice nurses in geriatric traumatology : A scoping review].Zeitschrift fur Gerontologie und Geriatrie · 2024Article
- Advancing the practice of trauma: utilizing advanced practice providers to improve patient outcomes through a collaborative team approach.Trauma surgery & acute care open · 2024Review
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Authors and funding
7 authors.
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Abstract
backgroundBenchmark data from the Trauma Quality Improvement Program (TQIP) identified an opportunity for improvement in our trauma programme. Our unexpected return to the intensive care unit (ICU) was found to be higher than the national averages and we also noticed that our readmission rate had increased. We chose to address these complications as continuous quality improvement projects. It was hypothesized that restructuring the workflow of the trauma advanced practice providers (APPs) to focus on the delivery of comprehensive clinical care would decrease return to ICU and readmission rates of trauma patients.
methodsThe development of the APP programme occurred from 2012 to 2014. First, APP daily shifts were extended to mirror the resident physicians' coverage. Second, the APPs' original job description was expanded from 'task-oriented' workflow to providing comprehensive clinical care. Third, the APPs were involved in the evaluation and decision-making process for transferring trauma patients from the ICU. Finally, the APPs implemented a new discharge process that included all information in a standardized format and a follow-up phone call 24-48 hours after discharge. The trauma registry at our verified, academic level I trauma center was use to assess our ICU and hospital readmission rates during the time we instituted the new APP workflow programme.
resultsIn 2012, our ICU readmission rate was 5.7% (TQIP=1.9%) but then decreased to 4.4% in 2013 (TQIP=2.5%) and 2.1% in 2014 (TQIP=2.8%). Our hospital readmission rate was 2.0% in 2012 but then decreased to 1.38% and 0.96% over the next 2 years.
conclusionsAfter extending the APP service coverage, implementing a comprehensive clinical care model and standardizing the discharge process, our unplanned return to ICU rates have decreased to below the TQIP national average and hospital readmission rates have also decreased by half. LEVEL OF EVIDENCE: III.
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