Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jun 2013
Clinical TrialOutcomes after volar plate fixation of low-grade open and closed distal radius fractures are similar.
Low-grade (Gustilo and Anderson Type I or II) open distal radius fractures (DRFs) have been treated by volar locking plate fixation. However, it is unclear whether the outcomes after volar locking plate fixation for low-grade open DRFs are comparable to those for closed DRFs. ⋯ Although functional outcomes of open DRFs were inferior to those of closed DRFs at 3 months, at 1 year, outcomes of low-grade open DRFs were found to be comparable to those of closed DRFs when volar plate fixation was used.
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Clin. Orthop. Relat. Res. · Jun 2013
Developing a high-efficiency operating room for total joint arthroplasty in an academic setting.
Developing a high-efficiency operating room (OR) for total joint arthroplasty (TJA) in an academic setting is challenging given the preexisting work cultures, bureaucratic road blocks, and departmental silo mentalities. Also, academic institutions and aligned surgeons must have strategies to become more efficient and productive in the rapidly changing healthcare marketplace to ensure future financial viability. ⋯ Our project achieved improved OR efficiency and productivity using strategies such as process and resource analysis, improved communication, elimination of silo mentalities, and team work.
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Clin. Orthop. Relat. Res. · Jun 2013
Understanding how orthopaedic surgery practices generate value for healthcare systems.
Orthopaedic surgery practices can provide substantial value to healthcare systems. Increasingly, healthcare administrators are speaking of the need for alignment between physicians and healthcare systems. However, physicians often do not understand what healthcare administrators value and therefore have difficulty articulating the value they create in discussions with their hospital or healthcare organization. Many health systems and hospitals use service lines as an organizational structure to track the relevant data and manage the resources associated with a particular type of care, such as musculoskeletal care. Understanding service lines and their management can be useful for orthopaedic surgeons interested in interacting with their hospital systems. ⋯ There is increasing pressure for healthcare systems and hospitals to partner with orthopaedic surgeons. The peer-reviewed literature demonstrates there are limited resources for physicians to understand the value they create when attempting to negotiate with their hospital or healthcare organization. To effectively negotiate for resources to provide the best care for patients, orthopaedic surgeons need to claim and demonstrate the value they create in healthcare organizations.
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Clin. Orthop. Relat. Res. · Jun 2013
Aligning incentives in health care: physician practice and health system partnership.
The key to successfully aligning hospitals and physicians is financial integration and joint incentives for academic, quality, and clinical productivity. Many physician practices and health systems are moving toward closer integration, but mainly through consolidation and employment strategies. ⋯ A model of complete integration between an academic department and a health system is achievable through a systematic process of mission-based support.
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Clin. Orthop. Relat. Res. · Jun 2013
Critical roles of orthopaedic surgeon leadership in healthcare systems to improve orthopaedic surgical patient safety.
The prevention of medical and surgical harm remains an important public health problem despite increased awareness and implementation of safety programs. Successful introduction and maintenance of surgical safety programs require both surgeon leadership and collaborative surgeon-hospital alignment. Documentation of success of such surgical safety programs in orthopaedic practice is limited. ⋯ Successful surgical safety programs require a culture of safety supported by all six key surgical safety program elements, active surgeon champions, and collaborative hospital and/or administrative support designed to enhance surgical safety and improve surgical patient outcomes. Further research measuring improvements from such surgical safety systems in orthopaedic care is needed.