A Dedicated Orthopedic Trauma Room Improves Efficiency While Remaining Financially Net Positive
Objectives: To determine the impact of dedicated orthopaedic trauma room (DOTR) implementation on operating room efficiency and finances.
Design: Retrospective cost-analysis.
Setting: Single midsized academic-affiliated community hospital in Toronto, Canada.
Participants: All patients that underwent the most frequently performed orthopedic trauma procedures (hip hemiarthroplasty, open reduction internal fixation of the ankle, femur, elbow and distal radius), over a four-year period from 2016-2019 were included.
Intervention: Patient data acquired for two-years prior to the implementation of a DOTR was compared to data acquired for a two-year period after its implementation, adjusting for the number of cases performed.
Main outcome measurements: The primary outcome was surgical duration. The secondary outcome was financial impact, including after-hours costs incurred as well as opportunity cost of displaced elective surgeries.
Results: 1960 orthopaedic cases were examined pre- and post-DOTR. All procedures had reduced total operative time post-DOTR (mean improvement of 33.4%). The number of daytime operating hours increased 21%, while after-hours decreased by 37.8%. Overtime staffing costs were reduced by $24,976 alongside increase in opportunity costs of $22,500. This resulted in a net profit of $2,476.
Conclusions: Our results support the premise that DOTRs improve operating room efficiency and can be cost efficient. Our study also specifically addresses the hesitation regarding potential loss of profit from elective surgeries. Widespread implementation can improve patient care while still remaining financially favourable.
Level of evidence: Economic Level III. See Instructions for Authors for a complete description of levels of evidence.