A dedicated craniofacial trauma team improves efficiency and reduces cost.

BACKGROUND

In this era of limited medical resources there is ever increasing pressure to lower costs, while preserving high-quality patient care. A dedicated craniofacial and skull base trauma team (SBT) was established at our Level I trauma center in July 1998. Previously, a rotating call panel of multiple private surgical subspecialists consulted on trauma patients with craniofacial or skull base injuries (Pre-SBT). This study was designed to assess the impact a dedicated craniofacial and skull base trauma team has on the cost and quality of patient care.

MATERIALS AND METHODS

A retrospective review of the trauma registry and charts was performed including all craniofacial and skull base trauma cases in the 18 months Pre-SBT and 18 months following the establishment of a SBT.

RESULTS

During the Pre-SBT period there were 29 craniofacial and skull base operations, whereas 28 such cases were performed by the SBT. The age, sex, injury severity score (ISS), mechanism of injury, and type of craniofacial/skull base injuries were comparable between groups. The SBT group demonstrated a reduction in the number of patients transferred to other institutions for definitive care (7 vs 1, P = 0.05) and statistically significant reduction in the number of subspecialty consultations (2.4 vs 1.3), time to operation (7.5 vs 3.0 days), and length of hospitalization (11.8 vs 6.8, all with P <or= 0.001). Additionally, hospital charges were markedly reduced in the SBT group (106,424 dollars vs 58,136 dollars, P < 0.01).

CONCLUSIONS

The addition of a dedicated craniofacial trauma team to a Level I trauma center provides more comprehensive care, improves efficiency, and reduces cost.