J Trauma
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The development of trauma systems reduces preventable mortality and the measurement of standardized complications creates further opportunity for improvement in morbidity. The annual incidence of complications in a trauma population has been previously reported but the frequency change over time in a single institution is not well studied. ⋯ This data suggests that most complications have a finite threshold despite the use of a stable trauma staff, implementation of standardized protocols, and emphasis on consistency of practice. Further reductions will require new research for disease-related treatment and new strategies for consistency and error reduction rather than our current models of continuous quality improvement.
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The guidelines for Level I trauma center verification require 1,200 admissions per year. Several studies looking at the relationship between hospital volume and outcomes after injury have reached conflicting conclusions. The goal of our study was to examine the relationship between patient volume and outcomes (mortality and length of hospital stay) in California's trauma centers. ⋯ In our study, hospital volume was not a good proxy for outcome. Low-volume centers appeared to have outcomes that were comparable to centers with higher volumes. Perhaps institutional outcomes rather than volumes should be used as a criterion for trauma center verification.