J. R. Gardner1, J. D. Wolfe1, W. Beck1, A. Bhavaraju1, M. K. Kimbrough1, B. Davis1, A. Privratsky1, M. Jupin1, J. Jensen1, R. Roberston1, K. Sexton1, J. R. Taylor1 1University of Arkansas for Medical Sciences,Department Of Surgery,Little Rock, AR, USA
Introduction:
Reduction of errors, as the result of inefficient patient hand-offs, has been a focus of interest in the Emergency General Surgery (EGS) field. High patient loads, and limited time to thoroughly conduct patient hand-offs during shift changes can result in errors in patient care. UAMS, a state-wide tertiary care center, changed its hand-off method from an email- based approach to a Morning Report (MR) model.
Methods:
Prior to MR, there was a lack of attending physician supervision during hand-offs between resident teams. The MR model instituted meetings between resident teams and 3 attending surgeons (night call, trauma day call, and EGS day call). The enterprise data warehouse was queried for all patients admitted to the Emergency General Surgery service from May 2014 until January 2018. Bivariate frequency statistics and linear regression analysis were performed using JMP Pro Version 13.2.1. Elixhauser categories were used for risk stratification.
Results:
2592 patients were analyzed in this study (pre-MR, n= 608; post-MR, n= 1984). The majority of patients were white males. The pre-MR cohort had an average age of 47.8 years compared to the post-MR cohort, 49.6 years (p= 0.253). 1484 patients had an operation, while 1108 did not. No significant difference in the number of comorbidities was found between pre and post-MR cohorts (p= 0.686). The LOS (days) for pre and post cohorts were (4.87 ± 7.9 and 4.13 ± 6.7, p= 0.019). Linear Regression showed procedures, Elixhauser Categories, Morning Report, age > 65, race, and gender were predictive of LOS.
Conclusion:
Attending supervised EGS MR is associated with a decreases length of stay. Further work needs to be done to quantify the effects of a MR system.
