Loading…

A Dedicated Satellite Trauma Orthopaedic Program Operating Room Safely Increases Capacity

BACKGROUND:Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center...

Full description

Saved in:
Bibliographic Details
Published in:Journal of bone and joint surgery. American volume 2018-05, Vol.100 (10), p.e70-e70
Main Authors: Waters, Peter M, Yang, Brian W, White, Doreen, Barth, Ellen, Chiang, Vincent, Mizrahi-Arnaud, Arielle, Sparks, William
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c3389-6b223659ef4d6085af4e29dca9a568d6c0ebd25f4cd0748c72ed4a0b30b0599c3
cites cdi_FETCH-LOGICAL-c3389-6b223659ef4d6085af4e29dca9a568d6c0ebd25f4cd0748c72ed4a0b30b0599c3
container_end_page e70
container_issue 10
container_start_page e70
container_title Journal of bone and joint surgery. American volume
container_volume 100
creator Waters, Peter M
Yang, Brian W
White, Doreen
Barth, Ellen
Chiang, Vincent
Mizrahi-Arnaud, Arielle
Sparks, William
description BACKGROUND:Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS:In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year. Nonemergency, non-multitrauma operative fracture cases presenting to our tertiary care facility emergency department or orthopaedic clinic were considered for satellite referral. Eligible patients required clearance for transfer via orthopaedic, emergency department, and anesthesia checklists. An opt-out policy was established for provider judgment or patient family concern to overrule transfer decisions. Selected patients were discharged home with satellite OR scheduling or approved for same-day satellite location admission. Short elective cases were performed when openings existed in the schedule. RESULTS:From June 1, 2016, through June 30, 2017, 480 cases (372 trauma, 108 elective) were completed in our satellite OR. The most common trauma cases that were treated in the satellite OR were type-II supracondylar humeral fractures (n = 76). Summer months averaged 41.75 trauma cases and 11.25 elective cases per month, with 3.15 trauma cases and 0.85 elective cases per day. Nonsummer months averaged 22.78 trauma cases and 7.00 elective cases per month, with 2.93 trauma and 0.90 elective cases per day. Of the 17 postoperative issues, the greatest number (n = 7 [41%]) involved symptomatic hardware. The remaining complications were not surgeon or geographic-site-specific. There were no intraoperative complications, compartment syndrome episodes, or patients who required transfer back to our tertiary care facility for unexpected or serious medical issues. CONCLUSIONS:With the proper screening protocols in place for appropriate patient selection, the use of a dedicated satellite orthopaedic trauma OR can increase capacity without compromising patient safety.
doi_str_mv 10.2106/JBJS.17.01368
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2039292852</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2039292852</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3389-6b223659ef4d6085af4e29dca9a568d6c0ebd25f4cd0748c72ed4a0b30b0599c3</originalsourceid><addsrcrecordid>eNo9kE1P3DAQhq2qFSyUY6-Vj71kGduxEx_ptuVDSFsVOHCyJvaETZtsUjsR2n9PlqW9zEijZ17pfRj7JGApBZjzm683d0tRLEEoU75jC6GVzoQqzXu2AJAis0rrY3aS0m8AyHMojtixtIWR0soFe7zg3yg0HkcK_G6ebduMxO8jTh3ydRw3_YB7gP-M_VPEjq8Hijg22yf-q--7-aemdsevtz4SJkp8hQP6Ztx9ZB9qbBOdve1T9vDj-_3qKrtdX16vLm4zr1RpM1NJqYy2VOfBQKmxzkna4NGiNmUwHqgKUte5D1DkpS8khRyhUlCBttarU_blkDvE_u9EaXRdk_zcA7fUT8lJUHauWmo5o9kB9bFPKVLthth0GHdOgNvbdHubThTu1ebMf36LnqqOwn_6n74ZyA_Ac9-OFNOfdnqm6DaE7bhxsBdupMokiBK0MJDNF2HVC1wifzs</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2039292852</pqid></control><display><type>article</type><title>A Dedicated Satellite Trauma Orthopaedic Program Operating Room Safely Increases Capacity</title><source>HEAL-Link subscriptions: Lippincott Williams &amp; Wilkins</source><creator>Waters, Peter M ; Yang, Brian W ; White, Doreen ; Barth, Ellen ; Chiang, Vincent ; Mizrahi-Arnaud, Arielle ; Sparks, William</creator><creatorcontrib>Waters, Peter M ; Yang, Brian W ; White, Doreen ; Barth, Ellen ; Chiang, Vincent ; Mizrahi-Arnaud, Arielle ; Sparks, William</creatorcontrib><description>BACKGROUND:Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS:In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year. Nonemergency, non-multitrauma operative fracture cases presenting to our tertiary care facility emergency department or orthopaedic clinic were considered for satellite referral. Eligible patients required clearance for transfer via orthopaedic, emergency department, and anesthesia checklists. An opt-out policy was established for provider judgment or patient family concern to overrule transfer decisions. Selected patients were discharged home with satellite OR scheduling or approved for same-day satellite location admission. Short elective cases were performed when openings existed in the schedule. RESULTS:From June 1, 2016, through June 30, 2017, 480 cases (372 trauma, 108 elective) were completed in our satellite OR. The most common trauma cases that were treated in the satellite OR were type-II supracondylar humeral fractures (n = 76). Summer months averaged 41.75 trauma cases and 11.25 elective cases per month, with 3.15 trauma cases and 0.85 elective cases per day. Nonsummer months averaged 22.78 trauma cases and 7.00 elective cases per month, with 2.93 trauma and 0.90 elective cases per day. Of the 17 postoperative issues, the greatest number (n = 7 [41%]) involved symptomatic hardware. The remaining complications were not surgeon or geographic-site-specific. There were no intraoperative complications, compartment syndrome episodes, or patients who required transfer back to our tertiary care facility for unexpected or serious medical issues. CONCLUSIONS:With the proper screening protocols in place for appropriate patient selection, the use of a dedicated satellite orthopaedic trauma OR can increase capacity without compromising patient safety.</description><identifier>ISSN: 0021-9355</identifier><identifier>EISSN: 1535-1386</identifier><identifier>DOI: 10.2106/JBJS.17.01368</identifier><identifier>PMID: 29762292</identifier><language>eng</language><publisher>United States: Copyright by The Journal of Bone and Joint Surgery, Incorporated</publisher><subject>Adolescent ; Adult ; Child ; Child, Preschool ; Emergency Service, Hospital ; Female ; Fractures, Bone - diagnosis ; Fractures, Bone - epidemiology ; Fractures, Bone - surgery ; Hospitals, Pediatric ; Hospitals, Satellite ; Humans ; Infant ; Male ; Operating Rooms ; Orthopedic Procedures ; Patient Selection ; Program Evaluation ; Tertiary Care Centers ; Young Adult</subject><ispartof>Journal of bone and joint surgery. American volume, 2018-05, Vol.100 (10), p.e70-e70</ispartof><rights>Copyright 2018 by The Journal of Bone and Joint Surgery, Incorporated</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3389-6b223659ef4d6085af4e29dca9a568d6c0ebd25f4cd0748c72ed4a0b30b0599c3</citedby><cites>FETCH-LOGICAL-c3389-6b223659ef4d6085af4e29dca9a568d6c0ebd25f4cd0748c72ed4a0b30b0599c3</cites><orcidid>0000-0001-9225-7580 ; 0000-0002-7152-9601 ; 0000-0002-4188-1129 ; 0000-0003-1588-0883 ; 0000-0002-4580-4438 ; 0000-0003-3678-5228 ; 0000-0001-8604-3594</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29762292$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Waters, Peter M</creatorcontrib><creatorcontrib>Yang, Brian W</creatorcontrib><creatorcontrib>White, Doreen</creatorcontrib><creatorcontrib>Barth, Ellen</creatorcontrib><creatorcontrib>Chiang, Vincent</creatorcontrib><creatorcontrib>Mizrahi-Arnaud, Arielle</creatorcontrib><creatorcontrib>Sparks, William</creatorcontrib><title>A Dedicated Satellite Trauma Orthopaedic Program Operating Room Safely Increases Capacity</title><title>Journal of bone and joint surgery. American volume</title><addtitle>J Bone Joint Surg Am</addtitle><description>BACKGROUND:Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS:In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year. Nonemergency, non-multitrauma operative fracture cases presenting to our tertiary care facility emergency department or orthopaedic clinic were considered for satellite referral. Eligible patients required clearance for transfer via orthopaedic, emergency department, and anesthesia checklists. An opt-out policy was established for provider judgment or patient family concern to overrule transfer decisions. Selected patients were discharged home with satellite OR scheduling or approved for same-day satellite location admission. Short elective cases were performed when openings existed in the schedule. RESULTS:From June 1, 2016, through June 30, 2017, 480 cases (372 trauma, 108 elective) were completed in our satellite OR. The most common trauma cases that were treated in the satellite OR were type-II supracondylar humeral fractures (n = 76). Summer months averaged 41.75 trauma cases and 11.25 elective cases per month, with 3.15 trauma cases and 0.85 elective cases per day. Nonsummer months averaged 22.78 trauma cases and 7.00 elective cases per month, with 2.93 trauma and 0.90 elective cases per day. Of the 17 postoperative issues, the greatest number (n = 7 [41%]) involved symptomatic hardware. The remaining complications were not surgeon or geographic-site-specific. There were no intraoperative complications, compartment syndrome episodes, or patients who required transfer back to our tertiary care facility for unexpected or serious medical issues. CONCLUSIONS:With the proper screening protocols in place for appropriate patient selection, the use of a dedicated satellite orthopaedic trauma OR can increase capacity without compromising patient safety.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Emergency Service, Hospital</subject><subject>Female</subject><subject>Fractures, Bone - diagnosis</subject><subject>Fractures, Bone - epidemiology</subject><subject>Fractures, Bone - surgery</subject><subject>Hospitals, Pediatric</subject><subject>Hospitals, Satellite</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Operating Rooms</subject><subject>Orthopedic Procedures</subject><subject>Patient Selection</subject><subject>Program Evaluation</subject><subject>Tertiary Care Centers</subject><subject>Young Adult</subject><issn>0021-9355</issn><issn>1535-1386</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNo9kE1P3DAQhq2qFSyUY6-Vj71kGduxEx_ptuVDSFsVOHCyJvaETZtsUjsR2n9PlqW9zEijZ17pfRj7JGApBZjzm683d0tRLEEoU75jC6GVzoQqzXu2AJAis0rrY3aS0m8AyHMojtixtIWR0soFe7zg3yg0HkcK_G6ebduMxO8jTh3ydRw3_YB7gP-M_VPEjq8Hijg22yf-q--7-aemdsevtz4SJkp8hQP6Ztx9ZB9qbBOdve1T9vDj-_3qKrtdX16vLm4zr1RpM1NJqYy2VOfBQKmxzkna4NGiNmUwHqgKUte5D1DkpS8khRyhUlCBttarU_blkDvE_u9EaXRdk_zcA7fUT8lJUHauWmo5o9kB9bFPKVLthth0GHdOgNvbdHubThTu1ebMf36LnqqOwn_6n74ZyA_Ac9-OFNOfdnqm6DaE7bhxsBdupMokiBK0MJDNF2HVC1wifzs</recordid><startdate>20180516</startdate><enddate>20180516</enddate><creator>Waters, Peter M</creator><creator>Yang, Brian W</creator><creator>White, Doreen</creator><creator>Barth, Ellen</creator><creator>Chiang, Vincent</creator><creator>Mizrahi-Arnaud, Arielle</creator><creator>Sparks, William</creator><general>Copyright by The Journal of Bone and Joint Surgery, Incorporated</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9225-7580</orcidid><orcidid>https://orcid.org/0000-0002-7152-9601</orcidid><orcidid>https://orcid.org/0000-0002-4188-1129</orcidid><orcidid>https://orcid.org/0000-0003-1588-0883</orcidid><orcidid>https://orcid.org/0000-0002-4580-4438</orcidid><orcidid>https://orcid.org/0000-0003-3678-5228</orcidid><orcidid>https://orcid.org/0000-0001-8604-3594</orcidid></search><sort><creationdate>20180516</creationdate><title>A Dedicated Satellite Trauma Orthopaedic Program Operating Room Safely Increases Capacity</title><author>Waters, Peter M ; Yang, Brian W ; White, Doreen ; Barth, Ellen ; Chiang, Vincent ; Mizrahi-Arnaud, Arielle ; Sparks, William</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3389-6b223659ef4d6085af4e29dca9a568d6c0ebd25f4cd0748c72ed4a0b30b0599c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Emergency Service, Hospital</topic><topic>Female</topic><topic>Fractures, Bone - diagnosis</topic><topic>Fractures, Bone - epidemiology</topic><topic>Fractures, Bone - surgery</topic><topic>Hospitals, Pediatric</topic><topic>Hospitals, Satellite</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Operating Rooms</topic><topic>Orthopedic Procedures</topic><topic>Patient Selection</topic><topic>Program Evaluation</topic><topic>Tertiary Care Centers</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Waters, Peter M</creatorcontrib><creatorcontrib>Yang, Brian W</creatorcontrib><creatorcontrib>White, Doreen</creatorcontrib><creatorcontrib>Barth, Ellen</creatorcontrib><creatorcontrib>Chiang, Vincent</creatorcontrib><creatorcontrib>Mizrahi-Arnaud, Arielle</creatorcontrib><creatorcontrib>Sparks, William</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of bone and joint surgery. American volume</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Waters, Peter M</au><au>Yang, Brian W</au><au>White, Doreen</au><au>Barth, Ellen</au><au>Chiang, Vincent</au><au>Mizrahi-Arnaud, Arielle</au><au>Sparks, William</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Dedicated Satellite Trauma Orthopaedic Program Operating Room Safely Increases Capacity</atitle><jtitle>Journal of bone and joint surgery. American volume</jtitle><addtitle>J Bone Joint Surg Am</addtitle><date>2018-05-16</date><risdate>2018</risdate><volume>100</volume><issue>10</issue><spage>e70</spage><epage>e70</epage><pages>e70-e70</pages><issn>0021-9355</issn><eissn>1535-1386</eissn><abstract>BACKGROUND:Providing high-value care for urgent orthopaedic trauma patients requires effective and timely treatment. Herein, we describe the implementation of an innovative program utilizing the operating room (OR) capacity of a satellite campus to decrease stress on a pediatric tertiary care center without jeopardizing patient safety. METHODS:In addition to the daily emergency surgical room on the main campus, a dedicated orthopaedic trauma surgery OR was established in a satellite hospital location for 3 days per week in the summer and for 2 days per week for the rest of the year. Nonemergency, non-multitrauma operative fracture cases presenting to our tertiary care facility emergency department or orthopaedic clinic were considered for satellite referral. Eligible patients required clearance for transfer via orthopaedic, emergency department, and anesthesia checklists. An opt-out policy was established for provider judgment or patient family concern to overrule transfer decisions. Selected patients were discharged home with satellite OR scheduling or approved for same-day satellite location admission. Short elective cases were performed when openings existed in the schedule. RESULTS:From June 1, 2016, through June 30, 2017, 480 cases (372 trauma, 108 elective) were completed in our satellite OR. The most common trauma cases that were treated in the satellite OR were type-II supracondylar humeral fractures (n = 76). Summer months averaged 41.75 trauma cases and 11.25 elective cases per month, with 3.15 trauma cases and 0.85 elective cases per day. Nonsummer months averaged 22.78 trauma cases and 7.00 elective cases per month, with 2.93 trauma and 0.90 elective cases per day. Of the 17 postoperative issues, the greatest number (n = 7 [41%]) involved symptomatic hardware. The remaining complications were not surgeon or geographic-site-specific. There were no intraoperative complications, compartment syndrome episodes, or patients who required transfer back to our tertiary care facility for unexpected or serious medical issues. CONCLUSIONS:With the proper screening protocols in place for appropriate patient selection, the use of a dedicated satellite orthopaedic trauma OR can increase capacity without compromising patient safety.</abstract><cop>United States</cop><pub>Copyright by The Journal of Bone and Joint Surgery, Incorporated</pub><pmid>29762292</pmid><doi>10.2106/JBJS.17.01368</doi><orcidid>https://orcid.org/0000-0001-9225-7580</orcidid><orcidid>https://orcid.org/0000-0002-7152-9601</orcidid><orcidid>https://orcid.org/0000-0002-4188-1129</orcidid><orcidid>https://orcid.org/0000-0003-1588-0883</orcidid><orcidid>https://orcid.org/0000-0002-4580-4438</orcidid><orcidid>https://orcid.org/0000-0003-3678-5228</orcidid><orcidid>https://orcid.org/0000-0001-8604-3594</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 0021-9355
ispartof Journal of bone and joint surgery. American volume, 2018-05, Vol.100 (10), p.e70-e70
issn 0021-9355
1535-1386
language eng
recordid cdi_proquest_miscellaneous_2039292852
source HEAL-Link subscriptions: Lippincott Williams & Wilkins
subjects Adolescent
Adult
Child
Child, Preschool
Emergency Service, Hospital
Female
Fractures, Bone - diagnosis
Fractures, Bone - epidemiology
Fractures, Bone - surgery
Hospitals, Pediatric
Hospitals, Satellite
Humans
Infant
Male
Operating Rooms
Orthopedic Procedures
Patient Selection
Program Evaluation
Tertiary Care Centers
Young Adult
title A Dedicated Satellite Trauma Orthopaedic Program Operating Room Safely Increases Capacity
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-13T04%3A49%3A01IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20Dedicated%20Satellite%20Trauma%20Orthopaedic%20Program%20Operating%20Room%20Safely%20Increases%20Capacity&rft.jtitle=Journal%20of%20bone%20and%20joint%20surgery.%20American%20volume&rft.au=Waters,%20Peter%20M&rft.date=2018-05-16&rft.volume=100&rft.issue=10&rft.spage=e70&rft.epage=e70&rft.pages=e70-e70&rft.issn=0021-9355&rft.eissn=1535-1386&rft_id=info:doi/10.2106/JBJS.17.01368&rft_dat=%3Cproquest_cross%3E2039292852%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3389-6b223659ef4d6085af4e29dca9a568d6c0ebd25f4cd0748c72ed4a0b30b0599c3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2039292852&rft_id=info:pmid/29762292&rfr_iscdi=true