Impact of Acute Care Surgery to Departmental Productivity

Barnes, Stephen L.; Cooper, Christopher J.; Coughenour, Jeffrey P.; MacIntyre, Allan D.; Kessel, James W.

doi:10.1097/ta.0b013e3182307146

Cited by 37 publications

(35 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The main stimulus for ACS was mainly for the management of trauma in tertiary hospitals. Trauma management has increasingly become a non‐operative and underfunded area of surgery in the USA . In the USA, ACS remains a separate subspecialty with a dedicated fellowship programme …”

Section: Introductionmentioning

confidence: 99%

“…Trauma management has increasingly become a non-operative and underfunded area of surgery in the USA. 6 In the USA, ACS remains a separate subspecialty with a dedicated fellowship programme. 7 In Australia, the drive towards ASU was due to the increasing demand for EGS in public hospitals which was inadequately managed by the traditional on-call system.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

General Surgeons Australia's 12‐point plan for emergency general surgery

Ang

Wong

Truskett

2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

In the last decade, emergency general surgery (EGS) in Australia and New Zealand has seen a transition from the traditional on‐call system to the acute surgical unit (ASU) model. The importance and growing demand for EGS has resulted in the implementation of the General Surgeons Australia's 12‐point plan for emergency surgery. Since its release, the 12‐point plan has been used as a benchmark of a well‐functioning ASU, both locally and abroad. This study aims to provide a descriptive review on the relevance of the 12‐point plan to the ASU model and review the current evidence to support this framework. The review concludes that the establishment of the ASU model has met the aims set out by the Royal Australasian College of Surgeons for EGS. The 12‐point plan is relevant and has good evidence to support its framework.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

General Surgeons Australia's 12‐point plan for emergency general surgery

Ang

Wong

Truskett

2019

ANZ Journal of Surgery

View full text Add to dashboard Cite

show abstract

“…Some of these benefits include a reduction in time to consultation in the emergency department for nontrauma patients (5) and improved relativevalue unit productivity of emergency surgeons (6)(7)(8), including actual operative volume (9). Some of these benefits include a reduction in time to consultation in the emergency department for nontrauma patients (5) and improved relativevalue unit productivity of emergency surgeons (6)(7)(8), including actual operative volume (9).…”

mentioning

confidence: 99%

Increased ICU Resource Needs for an Academic Emergency General Surgery Service*

Lissauer¹,

Galvagno²,

Rock³

et al. 2014

Critical Care Medicine

View full text Add to dashboard Cite

Emergency general surgery patients have increased ICU needs in terms of length of stay, ventilator usage, and continuous renal replacement therapy usage compared with other services, perhaps due to the higher percentage of transfers and emergent surgery required. These patients represent a distinct population. Understanding their resource needs will allow for better deployment of hospital resources.

show abstract

“…As ACS continues to flourish around the world, an increasing number of studies have emphasized the benefits of this care model for patients with general surgical emergencies [2,5,8,15-18]. Surgical departments, however, have historically been expensive to run because of the costly equipment, support staff, as well as the specialized nursing and medical staff required [19].…”

Section: Discussionmentioning

confidence: 99%

“…Miller et al [27] and Barnes et al [15] observed a 23% and 44% increase in operative productivity in terms of elective caseloads, respectively, but an overall decline in general surgery operative volumes because of a reduction in emergent cases [15]. However, neither study considered wait-times for elective cases.…”

Section: Discussionmentioning

confidence: 99%

Allocating operating room resources to an acute care surgery service does not affect wait-times for elective cancer surgeries: a retrospective cohort study

et al. 2014

View full text Add to dashboard Cite

IntroductionAcute care surgical services provide timely comprehensive emergency general surgical care while optimizing the use of limited resources. At our institution, 50% of the daily dedicated operating room (OR) time allocated to the Acute Care Emergency Surgery Service (ACCESS) came from previous elective general surgery OR time. We assessed the impact of this change in resource allocation on wait-times for elective general surgery cancer cases.MethodsWe retrospectively reviewed adult patients who underwent elective cancer surgeries in the pre-ACCESS (September 2009 to June 2010) and post-ACCESS (September 2010 to June 2011) eras. Wait-times, calculated as the time between booking and actual dates of surgery, were compared within assigned priority classifications. Categorical and continuous variables were compared using chi-square and Mann–Whitney U tests respectively.ResultsA total of 732 cases (367 pre-ACCESS and 365 post-ACCESS) were identified, with no difference in median wait-times (25 versus 23 days) between the eras. However, significantly fewer cases exceeded wait-time targets in the post-ACCESS era (p <0.0001). There was a significant change (p = 0.027) in the composition of cancer cases, with fewer breast cancer operations (22% versus 28%), and more colorectal (41% versus 32%) and hepatobiliary cancer cases (5% versus 2%) in the post-ACCESS era.ConclusionThese results suggest that shifting OR resources towards emergency surgery does not affect the timeliness of surgical cancer care. This study may encourage more centres to adopt acute care surgical services alongside their elective or subspecialty practices.

show abstract

Impact of Acute Care Surgery to Departmental Productivity

Abstract: The ACS practice model significantly enhances provider productivity and job satisfaction when compared with trauma alone. Fears of a productivity impact to the nontrauma general surgeon were not realized.

Cited by 37 publications

References 19 publications

General Surgeons Australia's 12‐point plan for emergency general surgery

General Surgeons Australia's 12‐point plan for emergency general surgery

Increased ICU Resource Needs for an Academic Emergency General Surgery Service*

Allocating operating room resources to an acute care surgery service does not affect wait-times for elective cancer surgeries: a retrospective cohort study

Contact Info

Product

Resources

About