Quality of Integration of Air Force Trauma Surgeons Within the Center for Sustainment of Trauma and Readiness Skills, Cincinnati: A Pilot Study

• Published in: Military medicine 2024-08, Vol.189 (9-10), p.2100-2106
• Main Authors: Horn, Christopher B, Kopchak, Maura C, Pritts, Timothy A, Sams, Valerie G, Remick, Kyle N, Strilka, Richard J, Earnest, Ryan E
• Format: Article
• Language: English
• Subjects: Clinical Competence - standards; Clinical Competence - statistics & numerical data; Codes; Humans; Military Medicine - methods; Military Medicine - standards; Military Medicine - statistics & numerical data; Military personnel; Military Personnel - statistics & numerical data; Ohio; Pilot Projects; Surgeons; Surgeons - standards; Surgeons - statistics & numerical data; Terminology; Trauma care; Wounds and Injuries - surgery
• ISSN: 0026-4075; 1930-613X; 1930-613X
• DOI: 10.1093/milmed/usad441

ABSTRACT Introduction While previous studies have analyzed military surgeon experience within military–civilian partnerships (MCPs), there has never been an assessment of how well military providers are integrated within an MCP. The Center for Sustainment of Trauma and Readiness Skills, Cincinnati supports the Critical Care Air Transport Advanced Course and maintains the clinical skills of its staff by embedding them within the University of Cincinnati Medical Center. We hypothesized that military trauma surgeons are well integrated within University of Cincinnati Medical Center and that they are exposed to a similar range of complex surgical pathophysiology as their civilian partners. Materials and Methods After Institutional Review Board approval, Current Procedural Terminology (CPT) codes were abstracted from billing data for trauma surgeons covering University of Cincinnati Hospitals in 2019. The number of trauma resuscitations and patient acuity metrics were abstracted from the Trauma Registry and surgeon Knowledge, Skills, and Abilities clinical activity (KSA-CA) scores were calculated using their CPT codes. Finally, surgeon case distributions were studied by sorting their CPT codes into 23 categories based on procedure type and anatomic location. Appropriate, chi-squared or Mann–Whitney U-tests were used to compare these metrics between the military and civilian surgeon groups and the metrics were normalized by the group’s full-time equivalent (FTE) to adjust for varying weeks on service between groups. Results Data were available for two active duty military and nine civilian staff. The FTEs were significantly lower in the military group: military 0.583-0.583 (median 0.583) vs. civilian 0.625-1.165 (median 1.0), P = 0.04. Per median FTE and surgeon number, both groups performed a similar number of trauma resuscitations (civilian 214 ± 54 vs. military 280 ± 13, P = 0.146) and KSA-CA points (civilian 55,629 ± 25,104 vs. military 36,286 ± 11,267; P = 0.582). Although the civilian surgeons had a higher proportion of hernia repairs (P