UPMC Study: Patient Volume, Not Tenure, Key for Trauma Care

Survival rates of severely injured patients linked to EMS clinicians' caseload, not years of experience

Published on Feb. 24, 2026

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A recent study by UPMC and the University of Pittsburgh found that survival rates of severely injured trauma patients were correlated with the number of trauma patients treated by EMS clinicians, not their years of experience. The study reviewed data from over 3,600 patients treated by 359 EMS clinicians between 2017-2021, revealing that for every 5 additional patients an EMS clinician saw per year, there was a 10% decrease in the risk of mortality within 6 hours of injury.

Why it matters

This research challenges the assumption that more experienced EMS clinicians necessarily provide better trauma care. Instead, it suggests that increasing the volume of trauma cases EMS clinicians handle may be a more effective way to improve patient outcomes. The findings could inform policies and strategies to better support and train EMS personnel in treating severely injured patients.

The details

The study, published in JAMA Surgery, used data from the City of Pittsburgh's Bureau of EMS, STAT MedEvac, and the Linking Investigations in Trauma and Emergency Services research network. Researchers reviewed results from 3,649 severely injured trauma patients with an Injury Severity Score of 9 or higher, treated by 359 EMS clinicians. They found that improved patient survival was associated with the number of trauma patients treated at the individual EMS clinician level, not just the hospital or agency level. However, years of experience was not associated with any change in patient survival.

  • The study reviewed data from 2017 to 2021.
  • The study was published on February 18, 2026.

The players

UPMC

An integrated global health enterprise headquartered in Pittsburgh, Pennsylvania, that includes a renowned academic medical center and a network of community hospitals.

University of Pittsburgh School of Medicine

A medical school and academic department of the University of Pittsburgh, located in Pittsburgh, Pennsylvania.

Joshua Brown, MD

A UPMC trauma surgeon and Samuel P. Harbison Endowed Assistant Professor of Surgery at the University of Pittsburgh School of Medicine, who served as the senior author of the study.

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What they’re saying

“Getting EMS clinicians more exposure to traumas seems to be the key, but we can't just close EMS agencies and concentrate all the experience in one place — that would lead to longer wait times and worse outcomes.”

— Joshua Brown, MD, UPMC trauma surgeon and Samuel P. Harbison Endowed Assistant Professor of Surgery at the University of Pittsburgh School of Medicine (UPMC)

What’s next

UPMC outlined several strategies that could be implemented to further improve EMS clinician skills in treating severely injured patients, including developing national EMS quality benchmarking programs, using AI to build staffing models, expanding simulation and training tools, and creating mentorship programs between high- and low-volume EMS agencies.

The takeaway

This study challenges the conventional wisdom that more experienced EMS clinicians necessarily provide better trauma care. Instead, it suggests that increasing the volume of trauma cases EMS clinicians handle may be a more effective way to improve patient outcomes. The findings could lead to policy changes and new training approaches to better support and equip EMS personnel in providing high-quality trauma care.