Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
September 1, 2026Academic Emergency MedicineOpen Access

Emergency Department Guidelines for Orthopedic Consultation in an Academic Trauma Center: Effect on ED Throughput and Consultation Utilization

View Full Paper
Ask AI
Bookmark
Share

Authors

STSpencer TombergSTStacy A. TrentKJKathleen Joseph

Discussion

Loading...

Member takes

Overview

Retrospective before-after study demonstrates reduced length of stay and consults following orthopedic triage guidelines in trauma patients, suggesting improved emergency throughput.

Key Points

  • To evaluate the impact of institutional orthopedic consultation guidelines on emergency department length of stay, consultation frequency, and direct outpatient referrals.
  • Conducted a retrospective before-after study analyzing 4,013 emergency department patient visits with extremity or pelvis fractures between August 2021 and June 2023 at an academic Level-1 trauma center.
  • Implemented multidisciplinary injury-based guidelines defining criteria for in-person consultation, telephone consultation, or exclusive emergency clinician management.
  • Evaluated emergency department throughput and consultation metrics using multivariable difference-in-differences analysis and quantile regression.
  • Emergency department length of stay decreased by a median of 71 minutes (p < 0.001) following guideline implementation in adjusted difference-in-differences analysis.
  • In-person orthopedic consultations decreased by 5.5% (95% CI: -10.2, -0.8).
  • Outpatient referrals to orthopedics without an emergency department in-person consultation increased by 11.2% (95% CI: 7.8, 14.5).

Cite This Study

Tomberg et al. (2026) studied this question.

synapsesocial.com/papers/6aaa48c1b0403d670f6cb5a4https://doi.org/10.1111/acem.70402
View Full Paper
Ask AI
Bookmark
Share

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Evaluation of the impact of post-emergency visit on diagnostic and therapeutic changes in orthopedics.2026
  2. 2Reducing Appointment Time to Orthopaedic Specialist Outpatient Clinic for Emergency Department Patients with Fractures and Dislocations2026
  3. 3Impact of Adding an Orthopedic Surgery Residency Program in a Rural Trauma Center2025
  4. 4Geriatric screening in the emergency department increases consultations to geriatric medicine and physical and occupational therapy: A pre/post cohort study2024 · 8 citations
  5. 5The Effect of a Nursing Triage Protocol for Minor Orthopedic Trauma in an Emergency Department: A Randomized Controlled Trial2025