Implementation of a Dedicated Facial Trauma Operating Room at a Level 1 Trauma Center

Facial fracture repairs are often performed as add-on cases to work around elective schedules and emergent cases. This practice pattern can lead to delays in care and after-hours operations, longer hospital stays, operating room (OR) inefficiencies, and increased provider and staff burnout. To address this, we implemented a dedicated facial trauma OR model at our level 1 trauma center. A dedicated OR is available twice weekly and managed by the attending facial trauma surgeon on call. Any facial trauma case can be scheduled until 6 am on the same day, after which any unused OR time is then released to accommodate add-on cases. Pearson χ² tests, Fisher exact tests, and t tests were performed for statistical analysis. Analysis of mandibular fracture repairs after 1 year of implementation identified several important benefits compared with the previous add-on surgery model. After-hours operations, defined as operations after 5 pm, were reduced by 26.5% (P = 0.02). Several other variables showed improvement but did not reach statistical significance, including inpatient hospital length of stay (34.3% reduction), time from injury to surgery for inpatients (38.5% decrease), and the proportion of patients managed as outpatients (13.6% increase). Analysis of nasal fracture reductions during the period found a 24.8% reduction in OR time (P = 0.03). These results suggest that the dedicated facial trauma OR model has the potential to improve efficiency and should be further examined as a model for delivery of facial trauma care at major trauma centers.