This article is more than 5 years old. Information may no longer be current.
Use of a satellite orthopedic trauma OR may increase capacity
Click Here to Manage Email Alerts
Results published in The Journal of Bone and Joint Surgery showed use of a dedicated satellite orthopedic trauma OR may increase capacity without compromising patient safety with proper screening protocols for appropriate patient selection.
Peter M. Waters, MD, and colleagues established a dedicated orthopedic trauma surgery OR in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year in addition to the daily emergency surgical room on the main campus. Researchers considered nonemergency, non-multitrauma operative fracture cases that presented at a tertiary care facility emergency department or orthopedic clinic for satellite referral. When opening existed in the schedule, short elective cases were performed, according to researchers, and patients selected for transfer were discharged home with satellite OR scheduling or approved for same-day satellite location admission.
Among 480 cases completed in the satellite OR from June 2016 to June 2017, results showed type-II supracondylar humeral fractures were the most common trauma cases. Researchers noted an average of 41.75 trauma cases and 11.25 elective cases per month during the summer months with 3.15 trauma cases and 0.85 elective cases per day compared with an average of 22.78 trauma cases and seven elective cases per month during the non-summer months with 2.93 trauma cases and 0.90 elective cases per day. According to results, seven of the 17 postoperative issues involved symptomatic hardware, while the remaining complications were not surgeon or geographic site specific. Researchers found no intraoperative complications, compartment syndrome episodes or patients who required transfer back to the tertiary care facility for unexpected or serious medical issues.
“Managing orthopedic trauma in a level 1 pediatric center is greatly aided by cooperative triage of emergency, urgent and timely delayed cases into both the main hospital and satellite ORs,” Waters told Healio.com/Orthopedics. – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
Perspective
Back to Top
Andrew N. Pollak, MD
The experience reported by Waters and colleagues is similar to what we experienced in an adult population approximately 10 years ago when we made a concerted effort to move all cases out of our regional trauma referral center that could safely and effectively be completed at one of our community hospitals. The community hospital we selected is located approximately 1.5 miles from our trauma center. We made the move in order to increase efficiency, recognizing that we were facing limited OR capacity at the trauma center. We experienced improved turnover times, dramatically lower costs and improved surgeon satisfaction with completing the case at the alternative site despite the slight inconvenience factor. At the trauma center, we benefited from the decreased case burden.
While our assessment of our results has been less than rigorous, it certainly represents a consensus opinion among our trauma faculty that we have improved efficiency with no perceived increase in complications. Waters and colleagues are to be congratulated for carefully looking to determine that in their effort to increase efficiency and decrease cost, the move did not compromise safety.
Acting chair of physical therapy & rehabilitative science
Senior vice president for clinical transformation
University of Maryland Medical System
Click Here to Manage Email Alerts