Acute Care Surgery Survey

Tisherman, Samuel A.; Ivy, Michael E.; Frangos, Spiros G.; Kirton, Orlando C.

doi:10.1001/archsurg.2010.289

Cited by 17 publications

(3 citation statements)

References 22 publications

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“…In addition, it is often presumed that treating patients with pathologies associated with such high associated morbidity and mortality is less gratifying [29]. However, when there exists a coordinated and dependable system of care for patients, it permits surgeons, patients and institutions to align their objectives so as to achieve quality care while guaranteeing adequate lifestyle for the professionals [30, 31].…”

Section: Discussionmentioning

confidence: 99%

The Successful Implementation of a Trauma and Acute Care Surgery Model in Ecuador

et al. 2020

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Background For years, surgical emergencies in Ecuador were managed on a case-by-case basis without significant standardization. To address these issues, the Regional Hospital Vicente Corral Moscoso adapted and implemented a model of ''trauma and acute care surgery'' (TACS) to the reality of Cuenca, Ecuador. Methods A cohort study was carried out, comparing patients exposed to the traditional model and patients exposed to the TACS model. Variables assessed included number of surgical patients attended to in the emergency department, number of surgical interventions, number of surgeries performed per surgeon, surgical wait time, length of stay and in-hospital mortality.Results The total number of surgical interventions increased (3919.6-5745.8, p B 0.05); by extension, the total number of surgeries performed per surgeon also increased (5.37-223.68, p B 0.05). We observed a statistically significant decrease in surgical wait time (10.6-3.2 h for emergency general surgery, 6.3-1.6 h for trauma, p B 0.05). Length of stay decreased in trauma patients (9-6 days, p B 0.05). Higher mortality was found in the traditional model (p B 0.05) compared to the TACS model. Conclusions The implementation of TACS model in a resource-restrained hospital in Latin America had a positive impact by decreasing surgical waiting time in trauma and emergency surgery patients and length of stay in trauma patients. We also noted a statistically significant decrease in mortality. Savings to the overall system and patients can be inferred by decreased mortality, length of stay and surgical wait times. To our knowledge, this is the first implementation of a TACS model described in Latin America.

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Section: Discussionmentioning

confidence: 99%

The Successful Implementation of a Trauma and Acute Care Surgery Model in Ecuador

et al. 2020

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“…Both ACS and a fellowship training in ACS were born. 14,15 Several tertiary hospitals agree that the ACS teams are now the "general surgeons" with their three pillars of expertise: trauma, emergency general surgery (EGS), and critical care, [16][17][18][19][20][21][22][23][24] even though there is tremendous variation in the ACS models: 25% does EGS alone, 21% performs EGS and trauma, 17% EGS and elective surgery, while 30% perform all three. 25 A successful ACS system enables the collaboration between acute care surgeons, nonsurgical intensivists, elective general surgeons, and medical staff administration.…”

Section: How H Av E Trauma a N D Trauma Surgeons Changed ?mentioning

confidence: 99%

“…Indeed, the model is now supported by "specialty surgeons" as well as hospital administrators. [16][17][18][19][20][21][22][23][24]26 In the context of finances, several studies documented a positive contribution margin from ACS model. [19][20][21] found that the number of operations by ACS group increased significantly compared with the mean of the 2 years preceding the service creation (1,639 vs 790/year; p = 0.007).…”

Section: How H Av E Trauma a N D Trauma Surgeons Changed ?mentioning

confidence: 99%

Four Decades of Trauma: Blood, Sweat, and Tears

Ivatury¹

2013

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Providing Care for Critically Ill Surgical Patients

Tisherman

2013

JAMA Surg

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Providing optimal care for critically ill and injured surgical patients will become more challenging with staff shortages for surgeons and intensivists. This white paper addresses the historical issues behind the present situation, the need for all intensivists to engage in dedicated critical care per the intensivist model, and the recognition that intensivists from all specialties can provide optimal care for the critically ill surgical patient, particularly with continuing involvement by the surgeon of record. The new acute care surgery training paradigm (including trauma, surgical critical care, and emergency general surgery) has been developed to increase interest in trauma and surgical critical care, but the number of interested trainees remains too few. Recommendations are made for broadening the multidisciplinary training and practice opportunities in surgical critical care for intensivists from all base specialties and for maintaining the intensivist model within acute care surgery practice. Support from academic and administrative leadership, as well as national organizations, will be needed.

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Acute Care Surgery Survey

Abstract: In academic medical centers, surgical intensivists already practice the ACS model but depend on many nonsurgeons. Surgical intensivists believe that ACS will not compromise care or education and will help maintain the field, although the effect on resident interest is unclear.

Cited by 17 publications

References 22 publications

The Successful Implementation of a Trauma and Acute Care Surgery Model in Ecuador

The Successful Implementation of a Trauma and Acute Care Surgery Model in Ecuador

Four Decades of Trauma: Blood, Sweat, and Tears

Providing Care for Critically Ill Surgical Patients

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