Acute care surgery and emergency general surgery: Addition by subtraction

The Journal of Trauma and Acute Care Surgery
Brandon Robert BrunsJose J Diaz

Abstract

The formation of Acute Care Surgery services leads to decreased time to treatment and improved outcomes for emergency general surgery (EGS) patients. However, minimal work has focused on the ideal care delivery system and team structure. We hypothesize that the implementation of a dedicated EGS team (separate from trauma and surgical critical care), with EGS-specific protocols and dedicated operating room (OR) time, will increase productivity and improve mortality. This is a retrospective review of financial and EGS registry data from fiscal year (FY) 12 to FY15. Data are from an academic, university-based EGS team composed of two acute care surgery attending surgeons, advanced practitioners (APs), residents, and a fellow. In FY12, processes were implemented to standardize paging of consults, patient sign-out with attending surgeons' and APs' participation, clinical/billing protocols, OR availability, and quality improvement. Outcomes included relative value units (RVUs), surgical case volume, charges/payments, and number of patient encounters. The secondary outcome was mortality. The χ test was used to compare mortality, and p < 0.05 was considered significant. Total patient encounters increased from 6,723 in FY 12 to 9,238 in...Continue Reading

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Citations

Apr 3, 2019·The Journal of Trauma and Acute Care Surgery·David D KeevenAndrew C Bernard
May 8, 2020·World Journal of Surgery·Mats J L van der WeeRigo Hoencamp
Sep 5, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Barbara EatonBrandon Bruns
Nov 25, 2020·The Journal of Surgical Research·Lauren E MatevishOscar D Guillamondegui
Mar 20, 2021·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Pietro FransveaUNKNOWN ERASO study group

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