Intermountain Health Lutheran Hospital in Lakewood, Colo., has launched its Direct-to-Operating Room (Direct-to-OR) initiative, which allows caregivers to transport patients with penetrating injuries such as stabbings, shootings, or impalements directly from the ambulance bay or helipad to the OR, bypassing emergency department processes.
The program is “designed to expedite lifesaving care for patients suffering from some of the most catastrophic injuries in traumatic incidents,” says the hospital. “By streamlining the pathway for trauma patients, the program aims to reduce the time it takes to get into surgery, minimize complications and blood loss, and improve overall outcomes.”
Jason Boitnott, Lutheran Hospital trauma performance improvement coordinator, explains the clinical driver behind the program: “A penetrating trauma causes bleeding that is almost impossible to stop outside of an operating room. You need to go in and stop it.”
Previously, the hospital would issue an overhead page for full trauma activation when emergency crews delivered such patients, upon which designated specialists from multiple disciplines would report to the ER to prepare to care for the patient. The patient would be stabilized and quickly prepared for surgery in the ER. “Now they go to the OR and that all takes place there,” said Mr. Boitnott.
The hospital’s stated goal is to move such patients from the ambulance bay or helipad to the dedicated trauma operating room in less than two minutes.
Trauma surgeons at the hospital had recommended the process change. “By reducing the steps between arrival and surgery, we’re not only saving time — we’re saving lives,” said Christopher Zaw-Mon, MD.
The hospital said the Direct-to-OR program resulted from “extensive planning and collaboration” among emergency medical services, surgical teams, and hospital leadership. Dress rehearsals and process improvement initiatives ensured that caregivers are prepared to deliver seamless, high-quality care from the moment a patient arrives. This week, the teams ran through a mock exercise, testing the capabilities and readiness of the program.
