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Cost Savings Opportunities in Perioperative Management of the Patients With Orthopaedic Trauma

Moody, Alastair E. BS; Moody, Catriona E. BS; Althausen, Peter L. MD, MBA

Journal of Orthopaedic Trauma: December 2016 - Volume 30 - Issue - p S7–S14
doi: 10.1097/BOT.0000000000000716
Supplement Article

Summary: Considerable opportunities for cost savings exist surrounding the perioperative management of patients with orthopaedic fracture and trauma. Scientific evidence is available to support each potential cost savings measure. Much of these data had been documented for years but has never been adhered to, resulting in millions of dollars in unnecessary testing and treatment. Careful attention to preoperative laboratory testing can save huge amounts of money and expedite medical clearance for injured patients. The use of a dedicated orthopaedic trauma operating room has been shown to improve resource utilization, decrease costs, and surgical complications. A variety of anesthetic techniques and agents can reduce operative time, recovery room time, and hospital lengths of stay. Strict adherence to blood utilization protocols, appropriate deep venous thrombosis prophylaxis, and multimodal postoperative pain control with oversight from dedicated hip fracture hospitalists is critical to cost containment. Careful attention to postoperative disposition to acute care and management of postoperative testing and radiographs can also be another area of cost containment. Institutional protocols must be created and followed by a team of orthopaedic surgeons, hospitalists, and anesthesiologists to significantly impact the costs associated with care of patient with orthopaedic trauma and fracture.

*University of Nevada School of Medicine, Reno, NV; and

Reno Orthopaedic Clinic, Reno, NV.

Reprints: Peter L. Althausen, MD, MBA, Reno Orthopaedic Clinic, 555 North Arlington Avenue, Reno, NV 89503-4724 (e-mail:

Supported by research grant from Smith & Nephew.

P. L. Althausen has stock ownership in the Orthopaedic Implant Company. The remaining authors report no conflict of interest.

Accepted September 15, 2016

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