NDLI: The organizational and financial viability of an orthopedic trauma service.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Harris, Mitchel B. Cayen, Barry
Description	Country affiliation: United States Author Affiliation: Harris MB ( Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. mbharris@partners.org)
Abstract	BACKGROUND: This study was designed to explore the effect of establishing an Orthopedic Trauma Service (OTS) on departmental revenue within an academic orthopedic department. The effect of the OTS on physician and resident perceptions of job satisfaction, education, and quality of patient care were also evaluated. METHODS: A proforma financial analysis was undertaken using an optimization model to predict the potential financial performance of an OTS before its implementation. Financial data were then collected prospectively for the first year of the OTS and compared with the preceding year's financial data. All residents and faculty in the department completed visual analog scale surveys after the formation of the service. RESULTS: While maintaining a fixed amount of work production (work relative value units [WRVUs]) per year, our model predicted an \$111,000 increase in departmental charges as a result of a shift in the elective case mix. After implementation of the OTS, elective charges/WRVU increased by 7.4% while trauma charges/WRVU increased by 2.6%. This, combined with a minor increase in departmental work volume (115,661 WRVUs pre-OTS vs. 117,577 WRVUs post-OTS) and an improvement in collections/charge (47-48%), yielded a departmental collection increase of 11% (\$1.1 million). Resident and faculty job satisfaction improved, as did the perception of the quality of trauma care that was being provided. CONCLUSIONS: The organization and implementation of an OTS within an academic orthopedic department can lead to an improved professional experience for residents and faculty, the perception of improved patient care for the trauma patient, and an increase in departmental revenue.
File Format	HTM / HTML
ISSN	00225282
Issue Number	6
Volume Number	67
e-ISSN	15298809
Journal	The Journal of Trauma: Injury, Infection, and Critical Care
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2009-12-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Organization & Administration Economics Orthopedics Humans Models, Organizational Quality Of Health Care Trauma Centers Discipline Traumatology Journal Article Job Satisfaction Workload
Content Type	Text
Resource Type	Article
Subject	Surgery Critical Care and Intensive Care Medicine

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