This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Sucov, A. Articles by Jay, G. Search for Related Content PubMed PubMed Citation Articles by Sucov, A. Articles by Jay, G. Pubmed/NCBI databases Medline Plus Health Information Fractures Pain Social Bookmarking                         What's this?

Peer Review and Feedback Can Modify Pain Treatment Patterns for Emergency Department Patients With Fractures

Brown University, Rhode Island Hospital, Department of Emergency Medicine, Providence, Rhode Island, asucov{at}lifespan.org

Andrew Nathanson, MD

Brown University, Rhode Island Hospital, Department of Emergency Medicine, Providence, Rhode Island

Jackie McCormick, RN

Brown University, Rhode Island Hospital, Department of Emergency Medicine, Providence, Rhode Island

Lawrence Proano, MD

Brown University, Rhode Island Hospital, Department of Emergency Medicine, Providence, Rhode Island

Steven E. Reinert, MS

Lifespan Information Services, Providence, Rhode Island

Gregory Jay, MD, PhD

Brown University, Rhode Island Hospital, Department of Emergency Medicine, Providence, Rhode Island

Consecutive fracture patients presenting to an adult (AED) or pediatric trauma center (PED) or a community teaching hospital (CED) were reviewed for treatment. Physicians received individual and group feedback. Data were dichotomized by age, gender, race and insurance status. Logistic regression analysis modeled variables approaching statistical significance. A total of 1454 patients participated in the study. The aggregate initial treatment rate was 54%, with no subgroup differences. Significant improvements were seen in all sites/subgroups; the final aggregate treatment rate was 84% (P < .001). PED and CED patients were less likely to receive treatment than AED patients (odds ratios = 0.49, 0.68). After feedback, whites were treated more often than were non-whites (84% vs 71%, P < .0001); CED alone did not show this pattern (odds ratios = AED 4.14, PED 2.67, CED1.28). Patients at all sites received improved pain treatment in association with directed feedback. Race and treatment site were significant factors.

Key Words: emergency • pain treatment • fracture

American Journal of Medical Quality, Vol. 20, No. 3, 138-143 (2005)
DOI: 10.1177/1062860604274384


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?