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Improvements seen with implementation of physician anesthesiologists into fragility fracture service
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After the implementation of physician anesthesiologists into a fragility fracture service, investigators found a statistically significant decrease in emergency room to OR time and decreased length of stay and hospital costs, according to a presentation at the Anesthesiology Annual Meeting.
“This is another example of the importance of the physician anesthesiologist within the perioperative surgical home,” lead researcher of the study, Patrick Stafford, MD, an anesthesiology resident at Beaumont Hospital in Royal Oak, Michigan, said in a press release from the American Society of Anesthesiologists. “Before the program, physician anesthesiologists at the hospital often would not see a patient until they were ready for surgery. In some cases, the physician anesthesiologist would see a patient and realize they needed to have testing for heart or lung issues, or hemoglobin levels. Surgery would be delayed if the tests showed the patient was not ready or suitable for surgery.”
Researchers identified patients older than 50 years of age with a fragility fracture treated with operative fixation between April 2011 and December 2017. Patients were categorized as admission before (308 study charts) or admission after the implementation of physician anesthesiologists in a fragility fracture service (2,485 study charts). The fragility fracture service was formed in 2012 by the departments of orthopedic surgery and anesthesiology at Beaumont Hospital.
Post fragility fracture service implementation charts were assessed for emergency room (ER) to OR time, fracture type, patient sex, BMI, length of stay and readmission after 30 days. Investigators compared mean and median data with standard deviation/error to determine significant change.
Results showed ER to OR times and length of stay achieved statistical significance, with an improvement seen in the ER to OR times from 48 to 34 hours. The length of stay also decreased from 8.12 to 7.12 days. Investigators noted the readmissions/revisits decreased pre- to post-implementation from 12.36% to 9.9%. The national average for inpatient hospitalization of a patient with a hip fracture was $699 per day; however, cost analyses are ongoing.
References:
Stafford P, et al. The role of physician anesthesiologists in a fragility fracture service. Presented at the Anesthesiology Annual Meeting; Oct. 13-17, 2018; San Francisco.
Disclosure: Stafford reports no relevant financial disclosures.