{"doi":"10.1097/ta.0b013e31829849e5","title":"The impact of implementing a 24/7 open trauma bed protocol in the surgical intensive care unit on throughput and outcomes","abstract":null,"journal":"Journal of Trauma and Acute Care Surgery","year":2013,"id":648313,"datarank":2.1178837964388784,"base_score":3.1780538303479458,"endowment":3.1780538303479458,"self_citation_contribution":0.47670807455219194,"citation_network_contribution":1.6411757218866865,"self_endowment_contribution":0.47670807455219194,"citer_contribution":1.6411757218866865,"corpus_percentile":null,"corpus_rank":null,"citation_count":23,"citer_count":21,"citers_with_citation_signal":18,"citers_with_endowment":18,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1689484,"name":"Matthew Bloom","orcid":null,"position":1,"is_corresponding":false},{"id":1689486,"name":"Heather Warren","orcid":null,"position":2,"is_corresponding":false},{"id":1689488,"name":"Nirvi Shah","orcid":null,"position":3,"is_corresponding":false},{"id":1376344,"name":"Tamara Casas","orcid":null,"position":4,"is_corresponding":false},{"id":1689489,"name":"Tyler Ewing","orcid":null,"position":5,"is_corresponding":false},{"id":1689490,"name":"Marko Bukur","orcid":null,"position":6,"is_corresponding":false},{"id":1689492,"name":"Rex Chung","orcid":null,"position":7,"is_corresponding":false},{"id":1689494,"name":"Eric Ley","orcid":null,"position":8,"is_corresponding":false},{"id":1689499,"name":"Daniel Margulies","orcid":null,"position":9,"is_corresponding":false},{"id":773939,"name":"Darren Malinoski","orcid":"0009-0002-1880-1482","position":10,"is_corresponding":false},{"id":1689482,"name":"Akash Bhakta","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"The impact of implementing a 24/7 open trauma bed protocol in the surgical intensive care unit on throughput and outcomes","abstract":"BACKGROUND: Increased emergency department (ED) length of stay (LOS) has been associated with increased mortality in trauma patients. In 2010, we implemented a 24/7 open trauma bed protocol in our designated trauma intensive care units (TICUs) to facilitate rapid admission from the ED. This required maintenance of a daily bump list and timely transferring of patients out of the TICU. We hypothesized that ED LOS and mortality would decrease after implementation. METHODS: The following data from patients admitted directly from the ED to any ICU were retrospectively compared before (2009) and after (2011) the implementation of a trauma bed protocol at a Level I trauma center: age, sex, Glasgow Coma Scale (GCS) score, shock on admission (systolic blood pressure < 90 mm Hg), mechanism, injury severity scores (Injury Severity Score [ISS] and Abbreviated Injury Scale [AIS] score), ED LOS, ICU readmission rates, and mortality. RESULTS: Of the patients, 267 (17%) of 1,611 before and 262 (21%) of 1,266 (p < 0.01) after the protocol were admitted directly to the ICU, despite similar characteristics. ED LOS decreased from 4.2 ± 4.0 hours to 3.1 ± 2.1 hours (p < 0.01) in all patients as well as patients with an ISS of greater than 24 (3.1 ± 2.5 vs. 2.2 ± 1.6, p < 0.05) and a head AIS score of greater than 2 (4.2 ± 4.9 vs. 3.1 ± 2.0, p = 0.01). Mortality was unchanged for all patients (9% vs. 8%, p = 0.58) but trends toward improved mortality were found after protocol implementation inpatients with an ISS of greater than 24 (30% vs. 13%, p = 0.07) and in patients with a head AIS score of greater than 2 (12% vs. 6%, p = 0.08). A greater proportion of total patients were admitted to a designated TICU after implementation (83% vs. 93%, p < 0.01). ICU readmissions were unchanged (0.3% vs. 1.5%, p = 0.21). CONCLUSION: The implementation of a 24/7 open trauma bed protocol in the surgery ICU was associated with a decreased ED LOS and increased admissions to designated TICUs in all patients. Improved throughput was achieved without increases in ICU readmissions. LEVEL OF EVIDENCE: Therapeutic study, level IV.","is_dataset_classified":null,"base_score":3.1780538303479458,"endowment":3.1780538303479458,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"23778446","pmcid":null,"openalex_id":"https://openalex.org/W2319592038","authors":[],"funders":[],"total_grants":0,"fwci":2.9682,"citation_percentile":0.91428786,"influential_citations":0,"citation_trend":[{"year":2014,"count":2},{"year":2015,"count":5},{"year":2016,"count":3},{"year":2017,"count":2},{"year":2018,"count":4},{"year":2019,"count":2},{"year":2020,"count":5}],"oa_status":"closed","license":null,"oa_locations":[{"url":"https://journals.lww.com/10.1097/TA.0b013e31829849e5","host_type":"publisher"},{"url":"https://doi.org/10.1097/ta.0b013e31829849e5","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/23778446","host_type":"repository"}],"fields_of_study":["Trauma and Emergency Care Studies","Abdominal Trauma and Injuries","Emergency and Acute Care Studies","Adult","Aged","Arizona","Chi-Square Distribution","Cohort Studies","Critical Care","Crowding","Emergency Service, Hospital","Female","Follow-Up Studies","Glasgow Coma Scale","Health Plan Implementation","Hospital Mortality","Humans","Intensive Care Units","Length of Stay","Male","Middle Aged","Organizational Innovation","Patient Transfer","Retrospective Studies","Risk Assessment","Survival Analysis","Trauma Centers","Wounds and Injuries","Young Adult"],"mesh_terms":["Adult","Aged","Arizona","Critical Care","Crowding","Emergency Service, Hospital","Female","Follow-Up Studies","Health Plan Implementation","Humans","Intensive Care Units","Length of Stay","Male","Middle Aged","Organizational Innovation","Patient Transfer","Retrospective Studies","Trauma Centers","Wounds and Injuries","Cohort Studies","Glasgow Coma Scale","Chi-Square Distribution","Survival Analysis","Hospital Mortality","Risk Assessment","Young Adult"],"keywords":["Medicine","Glasgow Coma Scale","Injury Severity Score","Intensive care unit","Trauma center","Revised Trauma Score","Emergency department","Abbreviated Injury Scale","Emergency medicine","Major trauma","Anesthesia","Retrospective cohort study","Internal medicine","Injury prevention","Surgery","Poison control"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-10T02:29:01.509144Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}