Mathematical modeling to define optimum operating room staffing for pediatric patients in trauma centers.
BACKGROUND
Adult trauma centers (TCs) in the United States may be verified with an on-call operating room team if the performance improvement program shows no adverse outcome. Using queuing and simulation methodology, this study attempts to add a volume guideline for injured children.


METHODS
Data from 63 verified TCs identified demographic factors including specific information regarding the first pediatric trauma-related operation done between 11 pm and 7 am each month for 1 year.


RESULTS
The annual pediatric admits correlated with the number of operations (383) done from 11 pm to 7 am (P < .001). The probability of operation within 30 minutes of arrival varies with the number of admits and the percent of penetrating vs blunt injuries. This likely number of operations from 11 pm to 7 am beginning within 30 minutes of patient arrival would be 3.45, 4.21, and 4.95 for TCs admitting 150, 250, and 350 injured children per year, respectively. The probability that 2 rooms would be occupied simultaneously is 0.074 and 0.109 for centers with 160 and 260 pediatric trauma admissions, respectively.


CONCLUSIONS
Trauma centers performing less than 6 pediatric trauma operations per year from 11 pm to 7 am could conserve resources by using an on-call operating room team.
Department of Surgery, Wayne State University, Detroit, MI 48201, USA. david-tuggle@ouhsc.edu
David
D
Tuggle
Charles E
CE
Lucas
Robert L
RL
Coscia
James M
JM
Hurst
John W
JW
Meredith
John D
JD
Middleton
Charles R
CR
Rinker
Angie L
AL
Vlahos
Jack
J
Wilberger
D000776:Anesthesiology; D001509:Bed Occupancy; D002648:Child; D003198:Computer Simulation; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D013502:General Surgery; D006301:Health Services Needs and Demand; D006801:Humans; D008962:Models, Theoretical; D009871:Operating Room Nursing; D009873:Operating Rooms / Q000706:statistics & numerical data*; D010348:Patient Care Team; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D010820:Physicians / Q000600:supply & distribution*; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data; D013598:Systems Theory; D014193:Trauma Centers / Q000706:statistics & numerical data; D000078329:Workforce; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000601:surgery; D014950:Wounds, Penetrating / Q000453:epidemiology / Q000601:surgery