Scheduled Emergency Trauma Operation: The Green Line Orthopedic Trauma Surgery Process Of Care

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Healthcare Management

Background:

• Traditional orthopedic emergency care led to ward congestion and long waits for non-critical cases.
• The existing system often resulted in inefficient use of operating room resources.
• There was a need for a streamlined process to manage orthopedic trauma patient flow.

Purpose of the Study:

• To evaluate the effectiveness of a "green line" patient flow process in an orthopedic emergency setting.
• To assess the impact of this new system on hospital ward burden and operating room scheduling.
• To determine if scheduled emergency operations could be safely implemented for less urgent traumas.

Main Methods:

• Implemented a traffic light-based coding system categorizing urgency: green (>48h), yellow (8-48h), and red (<8h).
• Orthopedic trauma patients needing surgery but not immediate inpatient care (green) were managed via a "green line" process.
• These "green line" patients were discharged and scheduled for surgery during office hours.

Main Results:

• Between January 2010 and April 2015, 1830 "green line" operations and 5838 inpatient emergency operations were conducted.
• Common "green line" diagnoses included distal radial and finger fractures; hip fractures were most common for inpatients.
• Significant differences were observed in age, physical status, diagnoses, and procedures between "green line" and inpatient groups.

Conclusions:

• The "green line" process is a safe and effective approach to orthopedic trauma care.
• This system has the potential to optimize operating room time for more critical surgeries.
• The process can shorten hospital stays and reduce the need for off-hours emergency operations.