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A Dedicated Satellite Trauma Orthopaedic Program Operating Room Safely Increases Capacity.

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Area of Science:

  • Orthopaedic Surgery
  • Trauma Care
  • Healthcare Management

Background:

  • High-value care for urgent orthopaedic trauma necessitates efficient and timely treatment.
  • A pediatric tertiary care center faced challenges managing operating room (OR) capacity.
  • An innovative program was developed to leverage a satellite campus OR to alleviate strain on the main facility.

Purpose of the Study:

  • To describe the implementation of a satellite OR program for orthopaedic trauma.
  • To assess the program's impact on surgical capacity and patient safety.
  • To evaluate the feasibility of managing non-emergency, non-multitrauma fracture cases at a satellite location.

Main Methods:

  • Established a dedicated orthopaedic trauma surgery OR at a satellite hospital, operating 2-3 days weekly.
  • Referred eligible non-emergency, non-multitrauma fracture cases from the main campus to the satellite OR.
  • Implemented strict screening protocols including orthopaedic, emergency department, and anesthesia checklists, with an opt-out policy for overriding transfers.

Main Results:

  • Completed 480 cases (372 trauma, 108 elective) in the satellite OR over 13 months.
  • Supracondylar humeral fractures (Type II) were the most common trauma cases (n=76).
  • No intraoperative complications, compartment syndrome, or transfers back to the tertiary facility were reported; symptomatic hardware was the most frequent postoperative issue (n=7).

Conclusions:

  • A dedicated satellite orthopaedic trauma OR can successfully increase surgical capacity.
  • Proper patient selection and screening protocols are crucial for maintaining patient safety.
  • This model offers a safe and effective approach to managing orthopaedic trauma caseloads.