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The ORthopaedic Trauma Hospital Outcomes - Patient Operative Delays (ORTHOPOD) study.

Baldock, TE; Walshaw, T; Walker, R; Wei, N; Scott, S; Trompeter, AJ; Eardley, WGP; ORTHOPOD collaborators (see Supplementary material iii for compl (2023) The ORthopaedic Trauma Hospital Outcomes - Patient Operative Delays (ORTHOPOD) study. Bone Jt Open, 4 (6). pp. 463-471. ISSN 2633-1462 https://doi.org/10.1302/2633-1462.46.BJO-2023-0040.R1
SGUL Authors: Trompeter, Alex Joel

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Abstract

AIMS: This is a multicentre, prospective assessment of a proportion of the overall orthopaedic trauma caseload of the UK. It investigates theatre capacity, cancellations, and time to surgery in a group of hospitals that is representative of the wider population. It identifies barriers to effective practice and will inform system improvements. METHODS: Data capture was by collaborative approach. Patients undergoing procedures from 22 August 2022 and operated on before 31 October 2022 were included. Arm one captured weekly caseload and theatre capacity. Arm two concerned patient and injury demographics, and time to surgery for specific injury groups. RESULTS: Data was available from 90 hospitals across 86 data access groups (70 in England, two in Wales, ten in Scotland, and four in Northern Ireland). After exclusions, 709 weeks' of data on theatre capacity and 23,138 operations were analyzed. The average number of cases per operating session was 1.73. Only 5.8% of all theatre sessions were dedicated day surgery sessions, despite 29% of general trauma patients being eligible for such pathways. In addition, 12.3% of patients experienced at least one cancellation. Delays to surgery were longest in Northern Ireland and shortest in England and Scotland. There was marked variance across all fracture types. Open fractures and fragility hip fractures, influenced by guidelines and performance renumeration, had short waits, and varied least. In all, nine hospitals had 40 or more patients waiting for surgery every week, while seven had less than five. CONCLUSION: There is great variability in operative demand and list provision seen in this study of 90 UK hospitals. There is marked variation in nearly all injuries apart from those associated with performance monitoring. There is no evidence of local network level coordination of care for orthopaedic trauma patients. Day case operating and pathways of care are underused and are an important area for service improvement.

Item Type: Article
Additional Information: © 2023 Author(s) et al. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/
SGUL Research Institute / Research Centre: Academic Structure > Institute of Medical & Biomedical Education (IMBE)
Journal or Publication Title: Bone Jt Open
ISSN: 2633-1462
Language: eng
Dates:
DateEvent
23 June 2023Published
Projects:
Project IDFunderFunder ID
UNSPECIFIEDBritish Orthopaedic Associationhttp://dx.doi.org/10.13039/100008602
PubMed ID: 37350770
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/116851
Publisher's version: https://doi.org/10.1302/2633-1462.46.BJO-2023-0040.R1

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