Does a Dedicated Orthopaedic Day Surgery List Improve Delivery of Trauma Services?

Bhamra, Jagmeet; Dhinsa, Baljinder; Patel, S N; Davies, C. K.; Oliver, Matthew

doi:10.1177/175045891702701105

Cited by 5 publications

(9 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Whilst Cairns has a significant caseload and acts as the major referral hospital for a large geographical area servicing 23 hospitals and health centres, it may not be reflective of trauma demands in other hospital precincts. Some of our findings may have yielded significance with greater numbers included in the study; however, the numbers were sufficiently powered to adequately assess the questions we asked regarding the outcomes of introducing a regular OTL and are in keeping with other studies in this area 5,13 …”

Section: Discussionsupporting

confidence: 57%

“…A consequence of this type of planning may be a reduction in overall time in hospital, which has been shown by others who have implemented equivalent OTLs. 13 LOS decreased for hand tendons post-OTL; however, it was not statistically significant.…”

Section: Discussionmentioning

confidence: 63%

“…As lesser acuity trauma, hand tendon injuries are subject to being postponed in lieu of more urgent operations or are knowingly planned for a later, more certain date. A consequence of this type of planning may be a reduction in overall time in hospital, which has been shown by others who have implemented equivalent OTLs 13 . LOS decreased for hand tendons post‐OTL; however, it was not statistically significant.…”

Section: Discussionmentioning

confidence: 84%

“…With all surgery being performed in a single centre, the number of operating surgeons was relatively low; however, we feel we have still provided a larger sample than some other studies in this area 13 …”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Patient outcomes in Tropical North Queensland after implementation of a dedicated orthopaedic trauma list

Knight

Gouk

Jorgensen

et al. 2021

ANZ Journal of Surgery

View full text Add to dashboard Cite

Background To assess patient outcomes after the introduction of a regular orthopaedic‐specific trauma list (OTL). Methods A retrospective analysis of 422 trauma cases was performed comparing patient outcomes after the introduction of the OTL. Four common traumatic injuries requiring operative intervention were considered; closed tibial fractures, intra‐capsular neck of femur fractures, displaced paediatric supracondylar humeral fractures and hand tendon injuries. The outcomes assessed included time from patient referral to theatre, time from admission to theatre, operative times, time of day operation commenced, consultant involvement, hospital length of stay (LOS), returns to theatre and mortality. Results Tibial fractures had an increased time from admission to theatre (0.46 days pre‐OTL versus 1.21 days post‐OTL, P = 0.01), hand tendons injuries had an increase in time from referral to theatre (1.06 days pre‐OTL versus 2.82 days post‐OTL, P = 0.001). Consultant involvement increased for supracondylar procedures (27% pre‐OTL versus 61% post‐OTL, P < 0.001) and tendinous hand injury repairs (5% pre‐OTL versus 37% post‐OTL, P < 0.001). There was a decrease in cases starting after 17:00 hours; however, no group reached statistical significance. There was a reduction in complications and shorter inpatient LOS, however; these were not statistically significant. There was no difference in overall operative times after OTL implementation; however, individual group differences existed between registrars and consultants. Conclusion Implementing regular orthopaedic trauma lists resulted in greater consultant involvement and was associated with decreased after‐hours operating. Delays to theatre increased from both time of referral and admission; however, this was not correlated with increases in significant harm.

show abstract

Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Patient outcomes in Tropical North Queensland after implementation of a dedicated orthopaedic trauma list

Knight

Gouk

Jorgensen

et al. 2021

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Frequently, trauma cases are added on to the end of elective lists or alternatively performed after hours on general emergency lists 2,3 . Further delays might also occur as a result from complex or emergency cases 4 . As a result, operations are often conducted out of hours, which in conjunction with trauma surgery has the potential for worse outcomes and high mortality 2,3,5 .…”

Section: Introductionmentioning

confidence: 99%

Introducing an orthopaedic trauma list to a regional hospital: Improved efficiencies and patient outcomes

Thompson

Seghol

Davis

et al. 2021

Australian J Rural Health

View full text Add to dashboard Cite

Problem The lack of dedicated theatre time for orthopaedic surgeries at a small rural hospital meant that operations were regularly performed after hours as well as on weekends. Design Retrospective observational audit. Setting Data were collected for 317 patients admitted for trauma surgery between August 2019 and March 2020 at Shoalhaven District Memorial Hospital, which has an orthopaedic service and acts as a referral hospital for a 4561‐km2 catchment on the South Coast of New South Wales. Key measures for improvement Decreased time to surgery, length of stay and proportion of after‐hours operating. Strategies for change To quantify patient outcomes demonstrating effectiveness of the trauma list in theatre operations at the hospital, providing evidence for adequate provision of care at the rural location A reduction in out‐of‐hours operations results in a significant financial saving to the hospital, as well as increased safety to patients. Effects of change Significantly more operations were performed before 16:00 hours as well as on a weekday. Trauma list patients have a shorter length of stay (4.82 vs 7.8 days). Patients prior to the trauma list waited on average 89 hours for surgery, whereas patients on the trauma list waited only 43 hours. Lessons Learnt A dedicated, twice‐weekly orthopaedic trauma list is able to significantly reduce after hours and weekend surgeries. Patients placed on the trauma list had a significantly shorter length of stay and time to surgery. We therefore recommend the usage of dedicated trauma lists at small, regional sites not just to achieve cost savings but also to improve the patient journey and keep patients closer and returning to the home sooner.

show abstract

Profile of orthopaedic day-case procedures at a district general hospital (retrospective study)

Aldhilan,

Tella

2023

J Orthop Surg Res

View full text Add to dashboard Cite

Background The outcomes of orthopaedic day-case procedures have been reported widely, but there is a lack of reports from secondary health facilities such as district hospitals. Aim We aimed to perform a retrospective analysis of patient records to capture the profile of day-case procedures performed. Materials and methods We conducted a retrospective analysis of day-case procedures at the dedicated Day Surgery Unit of a moderate-sized district hospital in Saudi Arabia between January 2021 and December 2022. The medical records of all the patients who had day-case procedures by the hospital's orthopaedic unit were analyzed. Results Within the study period, 71 out of 914 elective orthopaedic procedures were carried out as day-cases, giving a day-case surgery rate of 7.8%. The mean age was 25.3 ± 12.2 (range, 4–55 years), and the male-to-female ratio was 6:1. The spectrum of the procedures was dominated by implant removal in 59 cases (83.1%). Whilst the anaesthetic technique varied, all the patients were ASA class I or II. There were minor complications in 10 patients (14.0%), with 7 of them (9.8%) needing inpatient admission. There was no cancellation of cases in our study. Conclusion We found day-case procedures to be safe and effective but with low utilisation of the Day Surgery Unit, which can be improved through the development of a detailed protocol for day surgery in the hospital.

show abstract

Does a Dedicated Orthopaedic Day Surgery List Improve Delivery of Trauma Services?

Cited by 5 publications

References 2 publications

Patient outcomes in Tropical North Queensland after implementation of a dedicated orthopaedic trauma list

Patient outcomes in Tropical North Queensland after implementation of a dedicated orthopaedic trauma list

Introducing an orthopaedic trauma list to a regional hospital: Improved efficiencies and patient outcomes

Profile of orthopaedic day-case procedures at a district general hospital (retrospective study)

Contact Info

Product

Resources

About