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Record W4285588990 · doi:10.1097/bot.0000000000002461

A Dedicated Orthopaedic Trauma Room Improves Efficiency While Remaining Financially Net Positive

2022· article· en· W4285588990 on OpenAlexaffabout
Johnathan R. Lex, Aazad Abbas, Colby Oitment, Jesse Wolfstadt, Paul Wong, Jihad Abouali, Albert Yee, Hans J. Kreder, Jérémie Larouche, Jay Toor

Bibliographic record

VenueJournal of Orthopaedic Trauma · 2022
Typearticle
Languageen
FieldHealth Professions
TopicHealthcare Operations and Scheduling Optimization
Canadian institutionsUniversity of TorontoToronto East General HospitalSunnybrook Health Science CentreHealth Sciences CentreMount Sinai HospitalMcMaster University
Fundersnot available
KeywordsMedicineStaffingOrthopedic surgeryWorkloadRetrospective cohort studySurgeryTrauma centerEmergency medicineNursing

Abstract

fetched live from OpenAlex

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 orthopaedic trauma procedures (hip hemiarthroplasty, open reduction internal fixation of the ankle, femur, elbow and distal radius), over a 4-year period from 2016 to 2019 were included. INTERVENTION: Patient data acquired for 2 years before the implementation of a DOTR was compared with data acquired for a 2-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 and opportunity cost of displaced elective surgeries. RESULTS: One thousand nine hundred sixty 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%, whereas 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 $2476. 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 favorable. LEVEL OF EVIDENCE: Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.005
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Science and technology studies, Research integrity, Insufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.597
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0050.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0010.001
Science and technology studies0.0030.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.003
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.040
GPT teacher head0.346
Teacher spread0.306 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations15
Published2022
Admission routes2
Has abstractyes

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