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Operating Room Efficiency: Benefits of an Orthopaedic Traumatologist at a Level II Trauma Center.
J Orthop Trauma. 2013 Jul 28;
Authors: Althausen PL, Kauk JR, Shannon S, Lu M, O'Mara TJ, Bray TJ
Abstract
OBJECTIVES:: Fellowship trained orthopaedic traumatologists are presumably taught skill sets leading to 'best practice' outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared to general orthopaedic surgeons (GOS) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists vs. GOS at a level II trauma center.
DESIGN:: Retrospective Review SETTING:: Level II Community Based Trauma Hospital PATIENTS/PARTICIPANTS:: Patients who presented to the emergency room at our institution with fractures and orthopaedic conditions requiring surgical intervention from January 1,2010 to December 31, 2011.
INTERVENTION:: Operative fracture fixation by members of our orthopaedic trauma panel, including fellowship and non-trauma fellowship trained orthopaedic surgeons.
MAIN OUTCOME MEASUREMENTS:: Our institutional database was queried to determine operative times, surgical supply and implant costs, and surgery labor expenses. Patients were stratified according to those treated by our trauma panel's three traumatologists and those treated by the 15 GOS on our trauma panel. These two groups were then compared using standard statistical methods.
RESULTS:: 6449 total orthopaedic cases were identified and 2076 of these involved fracture care. 1199 patients were treated by traumatologists and 877 by GOS. There was no statistical difference detected in ASA score between trauma and non-trauma groups. Overall, the traumatologist group demonstrated significantly decreased procedure times when compare to the GOS group(55.6 min vs 75.8min, p<0.0001). In 16 of 18 most common procedure types, traumatologists were more efficient. This led to significantly decreased surgical labor costs($381.4 vs $484.8, p <0.0001), and surgical supply and implant costs($2567 vs $3003, p<0.0001).
CONCLUSIONS:: This study demonstrates that in our community based trauma system, fracture care provided by traumatologists results in improved utilization of hospital based resources when compared to equivalent services provided by GOS. Significantly decreased operative times, surgical labor expenses and supply and implant costs by the fellowship trained group represent enhanced control of the design, plan, execution and monitoring of orthopaedic trauma care. Traumatologists can provide leadership recommendations for operating room efficiency in community based orthopaedic trauma care models.
LEVEL OF EVIDENCE:: Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.
PMID: 23899770 [PubMed - as supplied by publisher]
Read more... http://www.ncbi.nlm.nih.gov/pubmed/23899770?dopt=Abstract
