From private to academic call: Implementation of a dedicated orthopaedic trauma room on hip-fracture timeliness and efficiency

Objective: Evaluate whether implementation of an academic trauma team and a dedicated orthopaedic trauma room (DOTR) reduces surgical delay and improves efficiency in hip fracture management at a Level III trauma center. Methods: Design: Retrospective comparative cohort study.Setting: Single Level III community trauma center.Patient selection criteria: Adults undergoing operative repair of hip or femoral neck fractures in 2022 (private group, PG) or 2023 (academic group, AG). Exclusions include door-to-operating-room time >10 days, dialysis, active infection, revision surgery, preoperative ICU admission.Outcome measures and comparisons: Primary outcome measured was door-to-operating-room time (DTOR); secondary outcomes included proportion with DTOR >36 h, DOTR start-time utilization, hospital length of stay (LOS), age, body mass index (BMI), and Charlson Comorbidity Index (CCI) score. Results: A total of 433 patients met criteria (PG = 200, AG = 233). Groups were similar in age, BMI, and CCI (all p > 0.05). Median DTOR fell from 20.5 h to 16.5 h after DOTR implementation (p < 0.001). The amount of patients waiting greater than 36 h decreased from 21 % to 6.0 % (p < 0.001). DOTR start-time utilization rose from 22.5 % to 35.0 % (p = 0.005). LOS decreased from 137 h to 131 h but was not significant (p = 0.184). Conclusions: A multidisciplinary academic trauma service with a morning DOTR was associated with shorter time to surgery and higher OR start-time utilization for hip fracture patients, with a favorable trend toward shorter hospitalization. Adopting a dedicated trauma room and structured communication can enhance efficiency and patient care in community trauma centers. Level of evidence: III.