Improved Outcomes in Treating Acute Biliary Disorders With a Shift-Based Acute Care Surgery Model

Abstract

Background As Acute Care Surgery and shift-based models increase in popularity, there is evidence of better outcomes for many types of emergency general surgery patients. We explored the difference in outcomes for patients with acute biliary disorders, treated by either Acute Care Surgery (ACS) model or traditional call model (TRAD) during the same period. Methods Retrospective review of patients undergoing laparoscopic cholecystectomy for acute biliary disease 2017-2018. Demographics, clinical presentation, operative details, and outcomes were compared. Results Demographics, clinical presentation, and complication rates were similar between groups. Time from surgical consult to operating room (Δ = −15.34 hours [−24.57, −6.12], P = .001), length of stay (Δ = −1.4 days [−2.45, −.35], P = .009), and total charges were significantly decreased in ACS group compared to TRAD (Δ$2797.76 [−4883.12, −712.41], P = .009). Conclusions Acute biliary disease can be managed successfully in an ACS shift-based model with reduced overall hospital charges and equivalent outcomes.

The acute care surgery model and elective surgery

“…[1][2][3][4][5][6][7] These efforts directly led to development of the ACS model. [8][9][10] In the past 15 years or so, numerous benefits of the ACS model of care have been noted from improved outcomes, [11][12][13][14][15][16] increased efficiency, 11,15,17 and better job satisfaction. [18][19][20] One of the most important benefits of the ACS model is increased interest in the field.…”

“…In the past 15 years or so, numerous benefits of the ACS model of care have been noted from improved outcomes, 11–16 increased efficiency, 11,15,17 and better job satisfaction 18–20 . One of the most important benefits of the ACS model is increased interest in the field 21 .…”