PTSD and surgical residents: Everybody hurts sometimes.

BACKGROUND: We aim to evaluate the prevalence of PTSD, its association with physician burnout, and risk factors for PTSD among surgical residents. METHODS: A cross-sectional national survey of surgical residents was conducted screening for PTSD. Causative traumatic stressors were queried, and thirty-one potential risk factors for PTSD were evaluated. RESULTS: A positive PTSD screen (PTSD+) was found in 22% of 582 surgical residents, and an additional 35% were "at risk" for PTSD. Traumatic experiences occurred most commonly as a PGY1, and the most common stressor was bullying. An increase in average hours of work per week (p < 0.001), a high-risk screen for PBO (p < 0.001), and feeling unhealthy (p = 0.001) were associated with an increasing prevalence of screening PTSD+. CONCLUSIONS: The prevalence of screening PTSD+ among surgical residents (22%) was more than three times the general population. Increased work-hours, a high-risk PBO screen, and reduced resident wellness were associated with screening PTSD+.

Trauma patients: I can't get no (patient) satisfaction?

BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) provides financial incentives to hospitals based on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction survey. This data is made publicly available on their website to be utilized by patients and insurers. Hospitals are profoundly interested in identifying patient populations that negatively contribute to overall patient satisfaction scores. Hospitals consider trauma patients "high risk" from a HCAHPS perspective, but there is no data to inform this opinion. The purpose of this study is to evaluate trauma patient satisfaction scores and their impact on overall patient satisfaction. METHODS: Three different analyses were performed. Group 1 was composed of ALL patients admitted to our hospital over a 7-month period who were administered a validated patient satisfaction survey by a 3rd party and compared patient satisfaction of trauma vs. non-trauma patients (ALL). Group 2 compared admitted patients with a specific ICD-9 procedure code to non-trauma patients who underwent a procedure with the same ICD-9 code (ICD). Group 3 examines patient satisfaction between three Level I Trauma Centers within our geographic area (TC). Patient satisfaction data of trauma vs non-trauma patients (ALL), those with a specific ICD-9 procedure code (ICD), and the 3 Level I Trauma Centers in our area (TC) were analyzed with the appropriate statistical test. RESULTS: In the ALL group, no difference in satisfaction was noted in 18/21 questions for trauma patients when compared to non-trauma patients at our hospital. In the ICD group, 57 ICD-9 procedure codes were analyzed. Of these, only patients who required spinal fusion secondary to trauma reported lower overall patient satisfaction. No meaningful difference was found in HCAHPS associated satisfaction between the Level I Trauma Centers in our area (TC). CONCLUSION: In contrast to commonly held opinion, trauma patients do not negatively contribute to overall patient satisfaction in our facility. Certain injuries may offer opportunities for improvement and efforts around improved physician-patient communication may be warranted. In the era of public reporting and financial penalties, surgeons should embrace patient satisfaction as it may be vital to the survival of the trauma center.