Complications and death at the start of the new academic year: Is there a july phenomenon?

Kenji Inaba, Gustavo Recinos, Pedro G R Teixeira, Galinos Barmparas, Peep Talving, Ali Salim, Carlos Brown, Peter Rhee, Demetrios Demetriades

Research output: Contribution to journalArticle

61 Citations (Scopus)

Abstract

Background: The "July Phenomenon" refers to the propensity for increased errors to occur with new housestaff, as they assume new responsibilities at the beginning of the academic year. The purpose of this study was to examine the impact of the new residents presenting in July at a high volume Level I Academic Trauma Center. Methods: The trauma registry at the Los Angeles County + University of Southern California Medical center was retrospectively reviewed to identify all injured patients admitted over a 5-year period ending in December 2006. All Morbidity and Mortality reports for the study period were reviewed to extract deaths and any complications classified as preventable or potentially preventable. Patients admitted in the first 2 months (July to August) of the academic year were compared with those treated at the end of the academic year (May to June). Baseline clinical and demographic characteristics were compared, and the rates of preventable and potentially preventable deaths and complications were determined for each of these groups. Results: During the 5-year study period, 24,302 injured patients were admitted. Of those, 8,151 were admitted during the period from May to August with 4,030 (49.4%) at the beginning of the academic year (July to August) and 4,121 (50.6%) at the end of the academic year (May to June). Overall, the average age was 35.1 ± 17.7 years, 77% were men with an Injury Severity Score of 8.4 ± 9.7 and 24.2% penetrating injury rate. When examining mortality, after adjustment for differences between the two groups, there was no difference between patients admitted at the beginning or at the end of the academic year (adjusted odds ratio [95% confidence interval]: 1.1 [0.8, 1.5], p = 0.52). However, when compared with the patients treated for their injuries in May to June, those treated at the beginning of the academic year had a significantly higher rate of preventable and potentially preventable complications (adjusted odds ratio [95% confidence interval]: 1.9 [1.1, 3.2], p = 0.013). Conclusions: At an academic Level I trauma center, admission at the beginning of the academic year was associated with an increased risk of errors resulting in preventable and potentially preventable complications; however, these errors did not impact mortality. Specific errors associated with this increased rate of preventable complications warrant further investigation.

Original languageEnglish (US)
Pages (from-to)19-22
Number of pages4
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume68
Issue number1
DOIs
StatePublished - Jan 2010

Fingerprint

Trauma Centers
Mortality
Wounds and Injuries
Odds Ratio
Confidence Intervals
Injury Severity Score
Los Angeles
Registries
Demography
Morbidity

Keywords

  • Academic year
  • Complications
  • July phenomenon
  • Preventable
  • Trauma

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

Cite this

Inaba, K., Recinos, G., Teixeira, P. G. R., Barmparas, G., Talving, P., Salim, A., ... Demetriades, D. (2010). Complications and death at the start of the new academic year: Is there a july phenomenon? Journal of Trauma - Injury, Infection and Critical Care, 68(1), 19-22. https://doi.org/10.1097/TA.0b013e3181b88dfe

Complications and death at the start of the new academic year : Is there a july phenomenon? / Inaba, Kenji; Recinos, Gustavo; Teixeira, Pedro G R; Barmparas, Galinos; Talving, Peep; Salim, Ali; Brown, Carlos; Rhee, Peter; Demetriades, Demetrios.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 68, No. 1, 01.2010, p. 19-22.

Research output: Contribution to journalArticle

Inaba, K, Recinos, G, Teixeira, PGR, Barmparas, G, Talving, P, Salim, A, Brown, C, Rhee, P & Demetriades, D 2010, 'Complications and death at the start of the new academic year: Is there a july phenomenon?', Journal of Trauma - Injury, Infection and Critical Care, vol. 68, no. 1, pp. 19-22. https://doi.org/10.1097/TA.0b013e3181b88dfe
Inaba, Kenji ; Recinos, Gustavo ; Teixeira, Pedro G R ; Barmparas, Galinos ; Talving, Peep ; Salim, Ali ; Brown, Carlos ; Rhee, Peter ; Demetriades, Demetrios. / Complications and death at the start of the new academic year : Is there a july phenomenon?. In: Journal of Trauma - Injury, Infection and Critical Care. 2010 ; Vol. 68, No. 1. pp. 19-22.
@article{d813e4e86426451c8d4269787afbcfad,
title = "Complications and death at the start of the new academic year: Is there a july phenomenon?",
abstract = "Background: The {"}July Phenomenon{"} refers to the propensity for increased errors to occur with new housestaff, as they assume new responsibilities at the beginning of the academic year. The purpose of this study was to examine the impact of the new residents presenting in July at a high volume Level I Academic Trauma Center. Methods: The trauma registry at the Los Angeles County + University of Southern California Medical center was retrospectively reviewed to identify all injured patients admitted over a 5-year period ending in December 2006. All Morbidity and Mortality reports for the study period were reviewed to extract deaths and any complications classified as preventable or potentially preventable. Patients admitted in the first 2 months (July to August) of the academic year were compared with those treated at the end of the academic year (May to June). Baseline clinical and demographic characteristics were compared, and the rates of preventable and potentially preventable deaths and complications were determined for each of these groups. Results: During the 5-year study period, 24,302 injured patients were admitted. Of those, 8,151 were admitted during the period from May to August with 4,030 (49.4{\%}) at the beginning of the academic year (July to August) and 4,121 (50.6{\%}) at the end of the academic year (May to June). Overall, the average age was 35.1 ± 17.7 years, 77{\%} were men with an Injury Severity Score of 8.4 ± 9.7 and 24.2{\%} penetrating injury rate. When examining mortality, after adjustment for differences between the two groups, there was no difference between patients admitted at the beginning or at the end of the academic year (adjusted odds ratio [95{\%} confidence interval]: 1.1 [0.8, 1.5], p = 0.52). However, when compared with the patients treated for their injuries in May to June, those treated at the beginning of the academic year had a significantly higher rate of preventable and potentially preventable complications (adjusted odds ratio [95{\%} confidence interval]: 1.9 [1.1, 3.2], p = 0.013). Conclusions: At an academic Level I trauma center, admission at the beginning of the academic year was associated with an increased risk of errors resulting in preventable and potentially preventable complications; however, these errors did not impact mortality. Specific errors associated with this increased rate of preventable complications warrant further investigation.",
keywords = "Academic year, Complications, July phenomenon, Preventable, Trauma",
author = "Kenji Inaba and Gustavo Recinos and Teixeira, {Pedro G R} and Galinos Barmparas and Peep Talving and Ali Salim and Carlos Brown and Peter Rhee and Demetrios Demetriades",
year = "2010",
month = "1",
doi = "10.1097/TA.0b013e3181b88dfe",
language = "English (US)",
volume = "68",
pages = "19--22",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Complications and death at the start of the new academic year

T2 - Is there a july phenomenon?

AU - Inaba, Kenji

AU - Recinos, Gustavo

AU - Teixeira, Pedro G R

AU - Barmparas, Galinos

AU - Talving, Peep

AU - Salim, Ali

AU - Brown, Carlos

AU - Rhee, Peter

AU - Demetriades, Demetrios

PY - 2010/1

Y1 - 2010/1

N2 - Background: The "July Phenomenon" refers to the propensity for increased errors to occur with new housestaff, as they assume new responsibilities at the beginning of the academic year. The purpose of this study was to examine the impact of the new residents presenting in July at a high volume Level I Academic Trauma Center. Methods: The trauma registry at the Los Angeles County + University of Southern California Medical center was retrospectively reviewed to identify all injured patients admitted over a 5-year period ending in December 2006. All Morbidity and Mortality reports for the study period were reviewed to extract deaths and any complications classified as preventable or potentially preventable. Patients admitted in the first 2 months (July to August) of the academic year were compared with those treated at the end of the academic year (May to June). Baseline clinical and demographic characteristics were compared, and the rates of preventable and potentially preventable deaths and complications were determined for each of these groups. Results: During the 5-year study period, 24,302 injured patients were admitted. Of those, 8,151 were admitted during the period from May to August with 4,030 (49.4%) at the beginning of the academic year (July to August) and 4,121 (50.6%) at the end of the academic year (May to June). Overall, the average age was 35.1 ± 17.7 years, 77% were men with an Injury Severity Score of 8.4 ± 9.7 and 24.2% penetrating injury rate. When examining mortality, after adjustment for differences between the two groups, there was no difference between patients admitted at the beginning or at the end of the academic year (adjusted odds ratio [95% confidence interval]: 1.1 [0.8, 1.5], p = 0.52). However, when compared with the patients treated for their injuries in May to June, those treated at the beginning of the academic year had a significantly higher rate of preventable and potentially preventable complications (adjusted odds ratio [95% confidence interval]: 1.9 [1.1, 3.2], p = 0.013). Conclusions: At an academic Level I trauma center, admission at the beginning of the academic year was associated with an increased risk of errors resulting in preventable and potentially preventable complications; however, these errors did not impact mortality. Specific errors associated with this increased rate of preventable complications warrant further investigation.

AB - Background: The "July Phenomenon" refers to the propensity for increased errors to occur with new housestaff, as they assume new responsibilities at the beginning of the academic year. The purpose of this study was to examine the impact of the new residents presenting in July at a high volume Level I Academic Trauma Center. Methods: The trauma registry at the Los Angeles County + University of Southern California Medical center was retrospectively reviewed to identify all injured patients admitted over a 5-year period ending in December 2006. All Morbidity and Mortality reports for the study period were reviewed to extract deaths and any complications classified as preventable or potentially preventable. Patients admitted in the first 2 months (July to August) of the academic year were compared with those treated at the end of the academic year (May to June). Baseline clinical and demographic characteristics were compared, and the rates of preventable and potentially preventable deaths and complications were determined for each of these groups. Results: During the 5-year study period, 24,302 injured patients were admitted. Of those, 8,151 were admitted during the period from May to August with 4,030 (49.4%) at the beginning of the academic year (July to August) and 4,121 (50.6%) at the end of the academic year (May to June). Overall, the average age was 35.1 ± 17.7 years, 77% were men with an Injury Severity Score of 8.4 ± 9.7 and 24.2% penetrating injury rate. When examining mortality, after adjustment for differences between the two groups, there was no difference between patients admitted at the beginning or at the end of the academic year (adjusted odds ratio [95% confidence interval]: 1.1 [0.8, 1.5], p = 0.52). However, when compared with the patients treated for their injuries in May to June, those treated at the beginning of the academic year had a significantly higher rate of preventable and potentially preventable complications (adjusted odds ratio [95% confidence interval]: 1.9 [1.1, 3.2], p = 0.013). Conclusions: At an academic Level I trauma center, admission at the beginning of the academic year was associated with an increased risk of errors resulting in preventable and potentially preventable complications; however, these errors did not impact mortality. Specific errors associated with this increased rate of preventable complications warrant further investigation.

KW - Academic year

KW - Complications

KW - July phenomenon

KW - Preventable

KW - Trauma

UR - http://www.scopus.com/inward/record.url?scp=75649116482&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=75649116482&partnerID=8YFLogxK

U2 - 10.1097/TA.0b013e3181b88dfe

DO - 10.1097/TA.0b013e3181b88dfe

M3 - Article

C2 - 20065752

AN - SCOPUS:75649116482

VL - 68

SP - 19

EP - 22

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 1

ER -