Value of a Dedicated Saturday Orthopaedic Trauma Operating Room

Objectives:To determine the effect of an additional scheduled operative day on length of stay, distribution of caseload, waiting time to surgery, and direct variable hospital costs.Design:Retrospective chart review.Setting:Urban level 1 trauma center.Patients:Consecutive operative tibia and femur fractures admitted from November 1, 2009, to October 31, 2011.Intervention:Addition of a dedicated Saturday orthopaedic trauma operating room.Main Outcome Measurements:Length of stay, distribution of caseload, and waiting time to surgery.Results:The overall length of stay for all trauma patients admitted with femur or tibia fractures was significantly reduced by 2.7 days from a mean of 14.0-11.3 days (P value 0.018). Additionally, there was a trend toward shorter waiting time to surgery (average reduction of 25.1 hours) for patients admitted on a Friday (48.6 vs. 23.5 hours, P value 0.06). Furthermore, there was an increase in the number of cases performed on Saturdays by 59% (6.2% of the total caseload), whereas the originally disproportionally high number of cases on Mondays was appropriately reduced by 33% (6.7% of the total caseload). The estimated direct variable cost savings per year for the hospital was $1.13 million.Conclusions:Overall, these findings support the continuation of a dedicated Saturday orthopaedic trauma operating room and can provide the foundation for other departments with similar circumstances to negotiate for more dedicated operative time on weekends to improve efficiency.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.