Simulation program for optimal orthopedic call: a modeling system for orthopedic surgical trauma call

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Health Systems Management

Background:

• Trauma centers require efficient orthopedic coverage to manage emergency cases.
• Current staffing models may not optimally align with patient volume and operational demands.
• Timely orthopedic consultation is critical for positive patient outcomes in trauma.

Purpose of the Study:

• To define optimal orthopedic staffing models for trauma centers using mathematical modeling.
• To identify thresholds for mandatory orthopedic backup call based on procedural volume.
• To analyze patient wait times for orthopedic consultation during trauma operations.

Main Methods:

• Utilized a mathematical modeling system with data from 2,325 patients across 82 trauma centers.
• Modeled patient admissions, operation times, and durations.
• Calculated wait times for orthopedic consults based on surgeon availability and case volume.

Main Results:

• A center with one orthopedic surgeon on call faces increasing patient wait times with higher procedural volumes (0.17 to 28 patients/year waiting >30 min for 25 to 300 procedures).
• With two surgeons on call, wait times remain minimal even at 300 procedures/year (1.3 patients/year waiting >30 min).
• Mandatory orthopedic backup call is deemed unnecessary for centers performing fewer than 100 emergent trauma procedures annually.

Conclusions:

• Mathematical modeling provides a data-driven approach to optimize orthopedic coverage in trauma centers.
• Trauma center procedural volume is a key determinant for the necessity of mandatory orthopedic backup call.
• Centers performing <100 emergent trauma procedures/year may not require dedicated orthopedic backup call.