Chih-Yuan Fu1, Hung-Chang Huang2, Ray-Jade Chen3, Hsun-Chung Tsuo4, Hsiu-Jung Tung4. 1. Department of Trauma and Emergency Surgery, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan. 2. Department of Trauma and Emergency Surgery, Taipei Medical University-Wan Fang Hospital, Taipei Medical University, No 111, Sec 3, Xinglong Rd, Taipei 11696, Taiwan. 3. Department of Trauma and Emergency Surgery, Taipei Medical University-Wan Fang Hospital, Taipei Medical University, No 111, Sec 3, Xinglong Rd, Taipei 11696, Taiwan. Electronic address: rjchen1008@gmail.com. 4. School of Medicine, Taipei Medical University, Taipei, Taiwan.
Abstract
BACKGROUND: Several reports have indicated the benefits of the acute care surgery (ACS) model in surgical outcomes. We tried to delineate the impact of the ACS model on surgical efficiency and quality. METHODS: Before the ACS model was implemented, abdominal surgical emergencies were evaluated by an on-call nontrauma general surgeon (pre-ACS model). An in-house trauma surgeon treated all patients with trauma or nontrauma abdominal surgical emergencies after the ACS model. Patients with acute appendicitis who underwent appendectomies were included. We conducted a pre- and poststudy to compare the time patients were in the emergency department and surgical qualities. RESULTS: There were 146 and 159 patients enrolled in the pre-ACS model and ACS model, respectively. The overall ED length of stay in the ACS model was significantly shorter than that in the pre-ACS model (300.3 ± 61.7 vs 719.1 ± 339.0 minutes, P < .001). Hospital LOS was also significantly shorter in the ACS model than in the pre-ACS model (2.44 ± 1.39 vs 3.83 ± 2.21 days, P = .022). CONCLUSION: The ACS model may improve abdominal surgical efficiency and quality. Our study results echoed the benefits of the implementation of the ACS model shown in North America.
BACKGROUND: Several reports have indicated the benefits of the acute care surgery (ACS) model in surgical outcomes. We tried to delineate the impact of the ACS model on surgical efficiency and quality. METHODS: Before the ACS model was implemented, abdominal surgical emergencies were evaluated by an on-call nontrauma general surgeon (pre-ACS model). An in-house trauma surgeon treated all patients with trauma or nontrauma abdominal surgical emergencies after the ACS model. Patients with acute appendicitis who underwent appendectomies were included. We conducted a pre- and poststudy to compare the time patients were in the emergency department and surgical qualities. RESULTS: There were 146 and 159 patients enrolled in the pre-ACS model and ACS model, respectively. The overall ED length of stay in the ACS model was significantly shorter than that in the pre-ACS model (300.3 ± 61.7 vs 719.1 ± 339.0 minutes, P < .001). Hospital LOS was also significantly shorter in the ACS model than in the pre-ACS model (2.44 ± 1.39 vs 3.83 ± 2.21 days, P = .022). CONCLUSION: The ACS model may improve abdominal surgical efficiency and quality. Our study results echoed the benefits of the implementation of the ACS model shown in North America.
Authors: Doris Sarmiento Altamirano; Amber Himmler; Oscar Chango Sigüenza; Raúl Pino Andrade; Nube Flores Lazo; Jeovanni Reinoso Naranjo; Hernán Sacoto Aguilar; Lenin Fernández de Córdova; Edgar Rodas; Juan Carlos Puyana; Juan Carlos Salamea Molina Journal: World J Surg Date: 2020-06 Impact factor: 3.352