Objective

The impact of trainees on inpatient patient care is incompletely understood. This study sought to discern the impact of trainees on patient outcomes and costs at a children's hospital in the community. We hypothesized that there would be no differences in patient outcomes and costs on an inpatient teaching service compared to a nonteaching service. As a secondary goal, we analyzed trainee evaluations.

Methods

The authors conducted a cohort study of patients hospitalized from October 1, 2016 to September 30, 2017 on an acute care unit in a children's hospital in the community. Using t test or Fisher exact test, the authors compared patient outcomes between teaching and nonteaching services including, length of stay, discharge times, readmission rates, rapid response team (RRT) calls, pediatric intensive care unit (PICU) transfers, hospital transfers, and costs.

Results

During the study period, there were 1066 patients admitted and discharged from the teaching service and 1038 from the nonteaching service. There were no statistically significant differences in patient demographics or patient complexity. Similarly, there were no differences in length of stay, discharge times, readmission rates, RRT calls, PICU transfers, hospital transfers or patient costs between services. Trainee evaluations of the inpatient experience were overwhelmingly positive.

Conclusions

In a children's hospital in the community, there were no significant differences in patient outcomes and costs on a teaching service compared to a nonteaching service. Furthermore, trainee evaluations suggested a favorable learning experience, illustrating the feasibility of incorporating trainees into inpatient care in a nontraditional learner setting.

中文翻译：

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社区儿童医院教学与非教学服务的比较

客观的

受训人员对住院病人护理的影响尚不完全清楚。本研究旨在了解学员对社区儿童医院患者预后和费用的影响。我们假设与非教学服务相比，住院教学服务的患者结果和费用没有差异。作为次要目标，我们分析了受训者的评估。

方法

作者对 2016 年 10 月 1 日至 2017 年 9 月 30 日期间在社区儿童医院急症室住院的患者进行了一项队列研究。使用t检验或 Fisher 精确检验，作者比较了教学和非教学服务之间的患者结果，包括住院时间、出院时间、再入院率、快速反应团队 (RRT) 呼叫、儿科重症监护室 (PICU) 转移、医院转移、和费用。

结果

研究期间，教学服务出院患者1066人，非教学服务患者1038人。患者人口统计学或患者复杂性没有统计学上的显着差异。同样，服务之间的住院时间、出院时间、再入院率、RRT 呼叫、PICU 转移、医院转移或患者费用也没有差异。实习生对住院经历的评价非常积极。

结论

在社区的儿童医院，与非教学服务相比，教学服务的患者结果和费用没有显着差异。此外，受训者评估表明了良好的学习体验，说明了在非传统学习者环境中将受训者纳入住院护理的可行性。