Utilization of Orthopaedic Trauma Surgical Time: An Evaluation of Three Different Models at a Level <scp>I</scp> Pediatric Trauma Center

Beebe, Allan; Arnott, Lindsay; Klamar, Jan; Kean, John R.; Klingele, Kevin E.; Samora, Walter

doi:10.1111/os.12209

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…The present study demonstrates an average increase in the number of orthopaedic cases performed per day with a subsequent decrease in the proportion of after-hours start cases with surgeon responsibility for case scheduling. The benefits of increased OR efficiency extend beyond the confines of the operating room, demonstrating improved clinical outcomes with daytime cases 3,10 and positive economic implications for the health system 11,12 .…”

Section: Discussionmentioning

confidence: 99%

Increased OR Efficiency with Surgeon-Managed Orthopaedic Blocks

Kleinsmith,

Kibble,

Doxey

et al. 2024

JOrthoBusiness

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Objectives: To analyze orthopaedic operative block time efficiency when scheduled by operating suite scheduling time versus dedicated group of orthopaedic surgeons and clinical leaders Design: Retrospective Review Setting: A Metropolitan Hospital Patients/Participants: All operative orthopaedic cases that took place between August 2018 and February 2023 in four dedicated orthopaedic operating rooms Intervention: Responsibility for OR schedule and block management was shifted into the hands of a dedicated group of orthopaedic surgeons and clinical leaders Main Outcome Measurements: Number of cases per day, operative time per day, number of after-hours cases, scheduled case length accuracy Results and Conclusions: On average, 13.4 ± 3.1 cases were done per day in the four orthopaedic ORs during the post-intervention (surgeon-scheduled) period compared to 11.3 ± 3.2 and 11.6 ± 2.8 in the pre-intervention and post-COVID periods, respectively (p < 0.001). Analysis of average percent deviation from scheduled time reveals a significantly lower average deviation during the post-intervention period (17.3 ± 19.3 %) when compared to the pre-intervention and post-COVID periods (18.7 ± 23.8% and 19.7 ± 24.0%, respectively; p = 0.003). Additionally, there was a greater than expected frequency of cases estimated accurately (within 10% of their actual operative time) during the post-intervention period (959, 45.1%; p<0.001). The present study demonstrates an average increase in the number of orthopaedic cases performed per day with subsequent decrease in proportion of after-hours case starts with surgeon responsibility for case scheduling. Key Words: Operating room efficiency; Surgical case scheduling; Orthopaedic surgery blocks Level of Evidence: Level IV

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Section: Discussionmentioning

confidence: 99%

Increased OR Efficiency with Surgeon-Managed Orthopaedic Blocks

Kleinsmith,

Kibble,

Doxey

et al. 2024

JOrthoBusiness

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“…The dedicated OR examined by Brusalis et al 2 reserved an unbooked OR all day on weekdays from 7:30 am to 5 pm for orthopaedic trauma cases. Beebe et al 8 compared three scheduling models (traditional 24-hour call with no dedicated trauma OR, half-day dedicated trauma OR, and full-day dedicated trauma OR) for the management of pediatric trauma patients.…”

Section: Discussionmentioning

confidence: 99%

“…We did not evaluate changes in rates of after-hour surgeries. Beebe et al 8 noted that after-hour surgeries dropped dramatically from 59% of cases to < 5%. Brusalis et al noted a reduction in the frequency of after-hour procedures by 48%.…”

Section: Discussionmentioning

confidence: 99%

“…6,7 Pediatric full-day or half-day dedicated orthopaedic ORs have been investigated and have shown a reduction in number of after-hour surgeries, wait time to surgery, LOS, and complications. 2,8 Given these potential benefits, our institution established an early morning dedicated orthopaedic trauma OR, before the start of the scheduled OR day, to facilitate timely scheduling of patients requiring urgent orthopaedic surgical treatment with an estimated case time of <60 minutes.…”

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confidence: 99%

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Dedicated Early Morning Orthopaedic Trauma Operating Room Is Associated With Shorter Time to Surgery and Decreased Length of Hospital Stay for Children Undergoing Surgical Treatment of Supracondylar Humerus Fractures: A Retrospective Cohort Study

Chen,

Hara,

Siddiqui

et al. 2023

J Am Acad Orthop Surg

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Introduction: The purpose of this study was to investigate whether the use of a dedicated early morning orthopaedic trauma operating room (OR) resulted in shorter wait times, decreased surgical times, decreased length of stay (LOS), and decreased complications in children treated with urgent surgical intervention for supracondylar humerus fractures. Methods: This retrospective comparative cohort study at a level I pediatric trauma center included patients younger than 12 years with supracondylar humerus fractures urgently treated with closed or open reduction and percutaneous pinning. Index surgical cases from April 28, 2013, to February 26, 2020, were included. Patients with prior humerus fracture, concomitant injuries, open fracture, pulseless supracondylar fracture, or missing data were excluded. Patients were analyzed based on the type of OR: dedicated early morning orthopaedic trauma OR or typical daytime orthopaedic OR. The primary outcome was time from presentation to surgery. Secondary outcomes included surgical time, complications, and LOS. Results: A total of 401 patients with a mean age of 5 ± 2 (range: 1 to 11) years and a mean follow-up of 2.0 ± 2.1 (range: 0.5 to 25.0) months were included, of whom 137 patients (34%) underwent surgery in the early morning dedicated orthopaedic trauma OR. The dedicated early morning orthopaedic OR group had significantly less time from presentation to surgery (7.5 versus 9.4 hours; P = 0.0002) and shorter LOS (21.0 versus 24.0 hours; P = 0.004) compared with children treated in the typical daytime orthopaedic OR. Surgical time (31.1 versus 32.6 minutes; P = 0.40) and complication rates (5.8% versus 4.9%; P = 0.65) were similar between the groups. No revision surgery was required in either group. Discussion: Surgical wait times were diminished with use of the dedicated early morning OR, as was LOS. Surgical times and complication rates were similar between groups. Institutions may consider adopting a dedicated early morning orthopaedic trauma OR to improve surgical wait times and decrease LOS. Level of evidence: III

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