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Fracture Apparatus Design and Protocol Optimization for Closed-stabilized Fractures in Rodents

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The Nasal Fracture Algorithm: A Case for Protocol-Driven Management to Optimize Care and Resident Work Hours.

Alexander Lanigan¹, Joshua Lospinoso², Sarah N Bowe³

¹1 Department of Otolaryngology-Head and Neck Surgery, San Antonio Military Medical Center, San Antonio, Texas, USA.

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery

|January 25, 2017

Summary

Implementing a standardized nasal fracture management algorithm improved otolaryngology resident training efficiency. This protocol-driven approach increased intervention rates and significantly reduced consultations, optimizing resident work hours under duty hour restrictions.

Keywords:

duty hour restrictions graduate medical education military medicine nasal bone fracture otolaryngology residency

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Area of Science:

Otolaryngology
Medical Education
Surgical Training

Background:

Resident duty hour restrictions have raised concerns about surgical training quality.
Nasal bone fracture management presents a specific area for evaluating training efficiency.

Purpose of the Study:

To assess if standardizing nasal fracture management in otolaryngology residency improves care and efficiency.
To analyze consultation trends, intervention rates, and resident work hour utilization for nasal fractures.

Main Methods:

A 1-year retrospective analysis of otolaryngology consults for isolated nasal fractures.
Development of an evidence-based algorithm for nasal fracture management following literature review.

Main Results:

Potential increase in intervention rate from 20% to 100% with algorithm utilization.
An 84% decrease in emergency room and inpatient consultations observed.
Estimated gain of 63 hours of resident time.

Conclusions:

Protocol-driven management of nasal fractures can enhance otolaryngology resident training efficiency.
This model may help mitigate challenges posed by Accreditation for Graduate Medical Education duty hour restrictions.
Standardized protocols can lead to more efficient patient care in otolaryngology.