Organization of orthopaedic trauma services: A survey of the Orthopaedic Trauma Association

Objectives: This study was undertaken to collect information about the orga nization of orthopaedic trauma services in different types of hospitals, wi th particular emphasis on hospital support arrangements in different practi ce situations. Design: A survey was sent to all members of the Orthopaedic Trauma Associat ion (OTA) as part of the organization's newsletter, Fractoids. In addition, the survey was distributed by the OTA's E-mail discussion list, ORT-1, Main Outcome Measurements: The survey included questions about the size and nature of the hospital, resident involvement, academic affiliation, number of orthopaedic physician staff, training of the staff, presence of an orga nized orthopaedic trauma service, distribution of call and patients, and ho spital support. Results: Fifty-seven responses were received from North American centers, o f which six were duplications. Responses came from institutions of all type s and sizes, although most came from urban, Level 1 trauma centers with aca demic affiliation. Twenty-nine hospitals had a designated orthopaedic traum a service, and twenty-six had a director. Eighteen institutions had ancilla ry staff (nurses, physician's assistants, etc.) assigned to the orthopaedic trauma service. Hospitals with an academic affiliation were statistically more likely to have a designated orthopaedic trauma service and to distribu te trauma patients by subspecialty expertise. In hospitals with a designate d orthopaedic trauma service or director, it was more common to have ancill ary support staff and to have it funded by the hospital, although the diffe rences did not rise to statistical significance. Conclusions: There are differences in organization of orthopaedic trauma ca re between hospitals, which may be related to hospital size, academic affil iation, and orthopaedic department organization. Further study is necessary to determine whether organizational differences translate into differences in patient outcome after trauma.