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Table 5 Main remarks about the features in the system level, processes, and management practices in the study hospitals

From: International benchmarking of tertiary trauma centers: productivity and throughput approach

Level of analysis Subject UKB HUS
System-level features Ownership & funding Worker's foundation owned academic hospital, primarily for occupational injuries, but not exclusive
60% of patients occupationally insured, others with private or social insurance
Public-funded university hospital
100% of patient care funded by municipalities' income taxes
  Organization of care All trauma patients (referred and non-referred) are taken care of Primary trauma care is usually not taken care of; mostly, referred patients are seen
  Catchment area Primary: 260,000
Secondary: 3.3 M (competing for customers with 5 tertiary trauma centers); calculated average, 550,000
Tertiary: 7.7 M (competing for customers with 9 tertiary trauma centers); calculated average, 770,000
Primary: 600,000
Secondary: 600,000
Tertiary: 1.5 M
Process and management features of trauma patients Acute patient volumes ED visits: 49,000 per year
ED admissions to hospital: 12,400 (25%)
Acute surgeries: 6,520 (for 4,660 patients)
Acute O&T surgeries: 2,280 (for 1,780 patients)
ED visits: 19,400 per year
ED admissions to hospital: 6,960 (36%)
Acute surgeries: 6,800 (for 5,140 patients)
Acute O&T surgeries: 3,550 (for 2,990 patients)
  Emergency department All patients admitted to the ED. Rapid response and patient categorization highlighted in the reception
Lean approach applied, especially in trauma team activations
IT system supports rapid response and shift to the next phase of care
Non-severe primary traumas are directed to other hospitals
Regional and national responsibility over care after catastrophes highlighted by the management
Focus on maintaining capacity and readiness to receive multi-traumas and multiple patient scenarios in any circumstances
  Pre-operative care Patient transferred directly to an operating room or a ward unit
Ward care conducted primarily in sub-specialty-focused ward units. High flexibility, however, between wards to accommodate patients from other sub-specialties
Most patients transferred to a dedicated ward unit for pre-operative trauma patients. Emergencies transferred directly to an operating room
"Green line" is used a lot to discharge less severe trauma patients from the ED and to schedule a surgery in a defined operating room session within several days
  Surgical care Large multi-specialty operating unit. In addition, a couple of operating rooms for day surgeries
Anesthesia induction conducted in a separate room in every surgery
One anesthesiologist is responsible for one operating room
Dedicated operating units for O&T, neurosurgery, plastic and reconstructive surgery, and day surgery
Anesthesia induction conducted in a separate room in a small part of surgeries
One anesthesiologist is responsible for one to three operating rooms
  Post-operative care Conducted in the same ward as pre-operative care. Integrated rehabilitation care; almost all patients are discharged to home Immediate post-operative care conducted in wards dedicated to certain injuries of different body parts
Rehabilitation conducted mainly in communal hospitals