The ORthopaedic Trauma Hospital Outcomes - Patient Operative Delays (ORTHOPOD) study.

Area of Science:

• Orthopaedic Surgery
• Healthcare Systems Analysis
• Trauma Care Management

Background:

• The UK's National Health Service faces challenges in managing orthopaedic trauma caseloads efficiently.
• Understanding variations in theatre capacity and surgical timing is crucial for optimizing patient outcomes.

Purpose of the Study:

• To assess theatre capacity, surgical cancellations, and time to surgery for orthopaedic trauma patients across UK hospitals.
• To identify barriers to effective practice and inform potential system improvements in trauma care delivery.

Main Methods:

• A prospective, multicentre study involving 90 UK hospitals.
• Data collection on weekly caseload, theatre capacity, patient demographics, and time to surgery over a defined period.
• Analysis of 709 weeks of theatre capacity data and 23,138 operations.

Main Results:

• Significant variability in operative demand and list provision across hospitals.
• Only 5.8% of theatre sessions were dedicated day surgery, despite 29% eligibility.
• 12.3% of patients experienced surgical cancellations; delays varied geographically and by fracture type.

Conclusions:

• Marked variations exist in orthopaedic trauma care delivery, with limited evidence of local network coordination.
• Underutilization of day case operating and care pathways represents a key area for service improvement.
• Performance monitoring appears to influence wait times for specific injuries like open and fragility hip fractures.