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Hours-long waiting times in an understaffed hospital Emergency Department affects not only patients’ clinical outcomes, but also patient satisfaction and your community reputation. What’s more, poor follow-up can make this situation even worse, causing  gaps in care that lead to avoidable medical errors that have significant financial implications and that impede your facility’s ability to grow.

So, ask yourself…”Can I count on my on-call general surgeons when minutes count? Does my hospital have the staffing model and processes to optimize those essential aspects of delivering effective, efficient emergency care?” If there’s a scintilla of doubt in your answer, your trauma and acute-care surgery program may need emergency care.

What are you doing to stop the hemorrhaging of patients, physicians, clinical staff and revenue as your ED volumes and reputation decline? Are you:

• Still trying to make do with the old-style coverage by rotating members of your community surgeons for on-call coverage?
• Forced to turn away emergency surgical patients due to lack of coverage? Or has your LEMSA already taken care of that…diverting patients because they know you’re ill-equipped to deal with their trauma patients in a timely fashion?
• Trying and failing to recruit and retain ED surgical specialists in your remote or underserved community because they don’t want to work and live there as a suitable career and family move?
• Still struggling with efficient care coordination and best-practice processes across ED surgeons and the rest of your hospital-wide care team? Handoffs between team members are where the greatest and most potentially deadly avoidable medical errors can occur.

Unfortunately, the versatile, broadly experienced general surgeons needed to provide timely, optimal emergency care are flocking to more-lucrative specializations and locations. Many simply don’t want the erratic schedules of ED coverage, especially as an “add-on” responsibility on top of their own private practice.

And frankly, community or locum tenens surgeons who rotate hospital shifts are not, by definition, a coordinated team. They lack the leadership and group mindset to create and follow shared protocols and procedures proven to save lives. This causes inconsistencies and AMEs that can lead to less-than-optimal clinical and financial outcomes, including the cost of readmissions.

Hundreds of hospitals are struggling, and even closing their doors, with the trend accelerating. Will yours be next if you don’t deal with this critical coverage issue?

The SAMGI answer: On-duty surgicalist coverage that delivers best practices

SAMGI (Surgical Affiliates Management Group, Inc.) has decades of experience helping resource-constrained client hospitals provide 24/7/365 on-duty coverage for acute-care and trauma surgeries. SAMGI’s turnkey program helps increase operational efficiency and ensure seamless integration with other hospital departments, including hospitalist programs. SAMGI’s teams are always available to provide the highest level of patient care while fostering integrated processes and care coordination across the hospital.

Led by a dedicated medical director, SAMGI’s teams include board-certified surgeons and other healthcare providers skilled in delivering in-house trauma, acute care, orthopedic, neurosurgery, urology, GI and general surgery services. SAMGI programs provide standardized care grounded in evidence-based best practices that help ensure consistent high-quality care utilizing standard approaches to clinical scenarios that reduce unnecessary tests or delays in care while optimizing clinical, financial and satisfaction outcomes.

What can SAMGI do for you? Click here to learn more about SAMGI and discover the kind of ROI that SAMGI can deliver by bringing its exceptional acute and trauma-level surgical expertise to your organization.

When patients are in life-threatening situations, they and their loved ones want only the best…and you want to be the one to deliver it. But even with a highly qualified medical staff, advanced technologies and sound practices in place, will your hospital be the one chosen by your local emergency management services authority (LEMSA)?

Most people know that designated trauma centers, particularly Level I regional centers, deliver the highest level of specialized, immediate trauma care — care that’s been shown to improve clinical outcomes: lower mortality rates, lower rates of disability at discharge, and better overall outcomes for severely injured patients. That commitment also creates a “halo effect” whereby requirements that are instituted for trauma patients are available to all patients in a facility, elevating hospital-wide care.

You may believe that becoming an American College of Surgeons (ACS)-verified trauma center is just too high a bar…one that requires significant investment in resources and process improvement your team can’t deliver alone while serving current patients. It’s true that ACS trauma verification is a complex process — including staffing standards such as immediate, on-site availability of an acute and trauma-level surgical team, and implementing coordinated, best-practice processes throughout the organization that can impact virtually every clinical department. Plus, it’s an ongoing commitment; the comprehensive verification process must be repeated every three years.

But without the designation, your ED, Surgery, Radiology, Lab, inpatient units and other revenue centers are losing the opportunity to help trauma patients and contribute to your financial goals that support ongoing community service. Is that because your LEMSA is routing critically injured patients past your doors to the nearest ACS-verified trauma center? So, at a time when minutes count for treating trauma patients, non-verified hospitals can fall well short of their goal to serve the community, enhance their reputation and sustain and grow the bottom line.

SAMGI on-duty surgicalists and knowledge of the ACS trauma verification process

SAMGI (Surgical Affiliates Management Group, Inc.) provides dedicated teams of board-certified surgeons and healthcare providers for in-house trauma, acute care, orthopedic, neurosurgery, urology, GI and general surgery services for communities and hospital systems. For decades we’ve been helping client hospitals achieve and maintain American College of Surgeons-verified trauma center designation.

As a national leader in establishing high-quality trauma and acute-care surgicalist programs, SAMGI provides its clients an unequaled depth of knowledge and expertise in acquiring and maintaining ACS trauma center verification. SAMGI’s surgeon-led leadership team has extensive experience with both the ACS verification process and state-specific site reviewers, giving our clients an effective depth of leadership and proficiency during every phase of the comprehensive ACS verification process.

SAMGI’s turnkey acute-care and trauma surgery program is led by a dedicated medical director who helps increase operational efficiency and ensure seamless integration with other hospital departments, including hospitalist programs. SAMGI’s teams are on-duty 24/7/365 to provide the highest level of patient care while integrating processes across hospital departments. SAMGI programs provide standardized care grounded in evidence-based best practices that help ensure consistent high-quality care and standard approaches to clinical scenarios that reduce unnecessary tests or delays in care and optimize clinical, financial and satisfaction outcomes.

Click here to learn more about SAMGI and discover the kind of ROI SAMGI can deliver to both your ACS verification achievement and your organization.

Like too many other hospitals, you may be turning away high-revenue emergency surgical cases — to your competitors — because you can’t depend on timely, reliable coverage when minutes count. What used to be a significant contributor to your bottom line, and your reputation for service to your community, is withering away.

Local surgeons with their own elective practices used to take turns rotating on-call ED coverage. That was a less-than-perfect model that delayed care, disrupted surgeons’ work/life balance and hurt their own practice’s bottom line.

Few today are willing to still do that, and well-rounded general surgeons are already in increasingly short supply; in an article in JAMA Surgery, it’s called a “looming crisis” since fewer than half of U.S. hospitals provide emergency general surgery care due to staffing shortages and total costs. With little growth projected for the supply of surgeons this decade — combined with a growing and aging population and the retirement of many currently practicing surgeons — demand is projected to outpace supply of surgeons by 19,800 to 29,000 by 2030.

Hospital leadership often struggles with the numerous factors involved in providing an effective and efficient trauma and acute-care surgery (TACS) program. Along with the overall shortage of surgeons, many hospitals in underserved rural or depressed urban areas simply aren’t competitive enough in their markets to attract and keep skilled acute and trauma-level surgeons who are available 24/7/365. It’s also not without cost, yet it remains key to generating revenue. Plus, the hospital remains committed to delivering a level of broad, readily available healthcare to its community.

Left unresolved, this lack of an efficient and well-staffed TACS program can cause the hospital to turn away the high-revenue emergency surgical cases that can mean the difference between overall profit or loss in departments throughout the organization — not only ED but surgery, anesthesia, radiology, laboratory, surgical nursing units and more.

The cure: SAMGI on-duty surgicalists

Emergency surgical revenue growth requires qualified, reliable on-duty trauma and acute care surgical coverage. It’s that simple…and yet that difficult. But that’s exactly what SAMGI (Surgical Affiliates Management Group) provides — board-certified or -eligible surgical teams dedicated to your hospital. No locum tenens. No on-call surgeons.

We partner with hospitals to provide superior 24/7/365 always on-duty emergency surgical services that help improve patient outcomes while optimizing hospital performance, efficiency and revenues. Peer-reviewed results published in the Journal of the American College of Surgeons have demonstrated that our evidence-based, standardized care programs deliver long-term excellence in patient care and optimization of overall hospital performance by improving workflow, efficiency and patient outcomes.

Unlike locum tenens surgeons, locally based SAMGI surgicalists work on a team of surgical partners to deliver best-practice, evidence-based emergency general, orthopedic, urology, GI and neuro surgical patient care. They’re not temps or fill-ins. They’re full-time surgery teams whose sole focus is to enable emergency patients at emergency surgical staffed-challenged hospitals to undergo surgery without unnecessary delays. There’s no waiting for local surgeons or other issues requiring transfers to tertiary-care hospitals with accredited trauma services farther from home.

They can mean all the difference between the health of your patients…and your bottom line.

Click here to learn more about SMAGI and to discover the kind of ROI a SAMGI surgicalist program can deliver.

If your facility is presenting any of the following four symptoms, it’s likely your trauma and acute-care surgery (TACS) operation is on life support. Your revenue is flat-lining and need some sort of an intervention to revive it.

1. 1. 1. Hospital leadership is struggling with ways to successfully grow revenues for your surgical program. Prognosis: A sagging bottom line that’s unsustainable.
      2. Your facility falls short of meeting American College of Surgeons-verified trauma center criteria that it is redirecting those patients to ACS-verified trauma centers. Prognosis: Business and revenue opportunities lost.
      3. You’re relying on local surgeons to provide emergency general surgical care — surgeons already busy with their own private practices. Prognosis: Stressed local physicians, care delayed, clinical outcomes potentially poorer, and business lost. Again.
      4. Patients are reporting dissatisfaction with overcrowded EDs, delayed procedures, disjointed follow-up and a lack of family communications. And they’re telling others. Prognosis: Bleak.

There’s no question the pandemic has caused a huge hit to most hospitals’ bottom line. Costs of providing care have shot up, qualified surgeons and professional staff are exhausted and in increasingly short supply, and many elective procedures are still being cancelled or postponed. As healthcare works to recover, no organization can afford to turn away badly needed and profitable business. That especially includes an efficient, effective TACS program, which typically generates critically needed revenue, contributes to high levels of organizational performance and fuels community goodwill, repeat patient, and positive name recognition.

To excel, your Emergency Department should be admitting at least 1% of total admissions as an acute care surgery case and achieve a CMI index greater than 2.09. It also should be achieving acceptable surgical patient lengths of stay, readmission, and complication rates. To do all that, it needs to deliver immediate care adhering to standardized best-practice guidelines, including exceptional post-surgical care coordination and communication across departments. Anything less will fall short of achieving your goals.

So what can you do to revive your TACS program, or take it to higher levels of performance? The first step is identifying what factors — your organization’s particular “symptoms”— are standing in the way of a return to strong financial health: a high-volume TACS cases, a CMI that’s 2.0 or greater, and shorter lengths of stay. The next step is to take action to treat them—a step where you might should consider a SAMGI surgicalist intervention.

SAMGI’s surgicalist solution

SAMGI (Surgical Affiliates Management Group) delivers a proven cure for these issues. We partner with hospitals to provide superior, evidence-based 24/7/365 always on-duty emergency surgical services that improve patient outcomes while optimizing hospital performance, efficiency and revenues. Peer-reviewed results published in the Journal of the American College of Surgeons have demonstrated that our evidence-based, standardized care programs deliver long-term excellence in patient care and optimization of overall hospital performance by improving workflow, efficiency and patient outcomes.

Unlike locum tenens surgeons, locally based SAMGI surgicalists work on a team of surgical partners to deliver best-practice, evidence-based emergency general, orthopedic, urology, GI and neurosurgical patient care. They’re not temps or fill-ins. They’re full-time surgery teams whose sole focus is to enable emergency patients at emergency surgical staffed-challenged hospitals to undergo surgery without unnecessary delays. There’s no waiting for local surgeons or other issues requiring transfers to tertiary-care hospitals with accredited trauma services farther from home.

Click here to learn more about SMAGI and to discover the kind of ROI a SAMGI surgicalist program can deliver.

Cashing in on a trifecta is a rare and major win. But, with a higher level of patient care, enhanced reputation and greater financial success, that’s what a rural hospital can achieve with a surgicalist program. And unlike at the racetrack, with SAMGI’s skill and expertise, little is left to chance.

Attracting the required team of high-caliber physicians has long been a challenge for rural hospitals. This includes surgeons in particular. The fact is that many physicians simply prefer less isolated environments.

Moreover, as surgical specialization becomes the norm, the broadly experienced general surgeon is rapidly becoming just a memory, diminishing the pool of surgeons appropriate for treating trauma and acute-care (TACS) cases. Drawing surgical talent from the local community comes with risks and potential pitfalls: lack of cohesive surgical leadership and standardized protocols and procedures, confusion at patient hand-off and possibly gaps in follow-up care. All this taxes already stretched clinical teams. This can this spell trouble. That’s a sure bet.

A Common Scenario

In America’s rural hospitals, the scenario is played out time and time again. Patients, possibly with pressing needs for immediate care, may wait hours in the emergency room for an on-call local surgeon. These surgeons are often tired and overworked, particularly if summoned in the middle of the night. If they never materialize, care is delayed as patients are transferred to hospitals in other communities far away from family and friends. Or, perhaps this trauma transfer is standard protocol. This often becomes a vicious cycle—eroding trust in local hospitals, diminishing their reputations, further hampering the ability to attract the needed surgeons and impacting the bottom line.

The Race is to the Swiftest

A surgicalist program can put rural hospitals on the same track as larger institutions in the race for success. It provides a contracted team of hand-picked board-certified or -eligible trauma and acute-care surgeons to meet a hospital’s needs to handle emergency cases 24/7/365 . Gambling on coverage with local surgeons is eliminated. SAMGI surgical teams function as part of hospital staff and the appropriate expertise is always available with highly qualified, motivated surgeons committed to a hospital’s success.

Through this model, smaller hospitals can enjoy high-caliber surgeons that they likely would not be able to recruit in-house, through traditional staffing agencies or as locum tenens. Surgeons participating in these programs enjoy an excellent work/life balance with predictable schedules. Much of the red tape surrounding private practice is eliminated, while physicians enjoy the rewards of their chosen medical field. They work with hospital leadership and function seamlessly as an integral part of the organization.

The Big Win

A SAMGI surgicalist program can mean hospitals are no longer forced to turn away complex emergency cases, their case mix index grows, and Centers for Medicare and Medicaid reimbursement increases. And with SAMGI’s intake through convalescence care model, they can provide post-op and ongoing care for their emergency patients, adding additional income. A hospital’s standing in the community and beyond increases. Recruitment of high caliber staff overall may be more successful. All this, in turn, enhances the hospital’s reputation and likely draws more patients. And of course, most important, those patients enjoy a far higher standard of care.

So, at the finish line, a surgicalist program delivers a real trifecta. Everyone’s a winner—patients, communities and hospitals. That’s what a good healthcare system is all about.

As a provider of surgicalist programs, SAMGI (Surgical Affiliates Management Group, Inc.) builds cohesive teams of high-performing, board-certified surgeons and advanced practice providers (APPs) that provide surgical care to hospitals from rural emergency and elective practices through busy Level II trauma centers. That makes it critical that we genuinely understand how to attract, identify, develop, engage, retain and deploy surgeons and advanced practitioners into a dedicated hospital setting.

Without giving away proprietary secrets, at the core of SAMGI’s methodologies is a talent management strategy that focuses on relationships and learning what is important to each surgeon and APP we meet. This helps align our business objectives and strategies with the talent necessary to support those of our client hospitals and create value for all parties. 

In providing our surgicalist programs to hospitals across the country, SAMGI implements planning methodologies to determine each program’s current and future surgeon and APP needs. We analyze supply and demand, current demographics, predictions for shortages or surpluses, and market and workplace trends for surgeons and APPs. Understanding these elements helps us focus on and prioritize our activities that include: 

•                     Talent acquisition
•                     Building talent pools
•                     Succession planning
•                     Leadership development
•                     Career management
•                     Lifelong learning
•                     Deployment
•                     Engagement
•                     Retention

Monitoring our talent management activities is important to our understanding of what is working to attract, retain, and control the costs associated with talent processes.

In addition, we approach our talent management strategy with a blend of inclusive and exclusive approaches. This allows us to work with our surgeons and client hospitals to reach and acquire surgeons and APPs from the widest possible talent pools. Integral to this method is how SAMGI leadership partners with hospital leadership to ensure the active involvement of all stakeholders. This allows us to prioritize the different stages from talent acquisition through retention.

We use proprietary tools that help us research surgeon and APP candidates and their backgrounds who have ties to specific geographies and locations. This is essential to filling positions with the right candidates. For example, for openings in a rural location requiring a surgeon or APP to live in that town/city, we seek and identify professionals who can relate to that lifestyle and who will become long-term, valued partners with their client hospital.   

We also work with some hospitals wishing to find surgeons and APPs who can drive or fly to their locations, work for one or two weeks, and then return. This successful model supports surgeons and APPs who want the surgicalist work/life balance but are unable to relocate.  

It all boils down to our talent management team determining the best strategy for each client and location and using our unique tools and techniques—our “secret sauce”—to acquire the best candidates for partnerships between surgeons, hospitals, and SAMGI. It’s a proven methodology refined over 25 years that allows our client hospitals to provide consistent, high-quality care to the patients in their communities.  

Author:

Tammy D. Hager, MBA, CPRP, FABC
Executive Director of Recruitment and Privileging

Many of us — especially in small towns and rural areas — grew up experiencing the wait in a hospital Emergency Department, anxiously watching for the surgeon on call to finally arrive. It was frightening for us, added stress for a harried doctor who’d already had a full day of scheduled operations and office visits, and could lead to less-than-optimal outcomes.

But there’s a proven, better way to serve surgeons, patients and hospitals alike — a surgicalist program that’s well-prepared for the unpredictable volumes of patients that occur.

No more juggling

A surgicalist (or surgical hospitalist) is a highly skilled, board-certified or -eligible surgeon who provides trauma and/or acute or emergency surgical care in a dedicated hospital setting…creating the foundation of a surgicalist program. The surgicalist model enables surgeons to help design the work/life balance they want, without the hassles and stress of juggling an office practice with elective operations and time on call.

Surgicalists enjoy professional and personal benefits unsurpassed in the surgical field.

Surgicalists with SAMGI (Surgical Affiliates Management Group) work on a team of surgical partners to deliver 24/7/365 emergency general, orthopedic and neuro-surgical patient care. This is their sole focus — enabling emergency patients at surgical-staffed hospitals to undergo surgery without delays, improving clinical and patient satisfaction outcomes, and hospital performance.

Surgicalists focus on what they love, not what they loathe

Surgicalists focus their time and talents on their passion — delivering exceptional surgical care — without the administrative worries of being a profitable private practice.

For too many surgeons, years of balancing an elective practice with the demands of on-call hospital duties have taken a great toll…on their physical and emotional health and well-being, personal/family lives, career satisfaction and, ultimately, cause higher rates of burnout.

Surgicalists, however, enjoy professional and personal unsurpassed benefits that delivers a rewarding balance that the old surgical model of balancing on-call duties and elective cases simply doesn’t provide. Since they’re focused exclusively on acute care and trauma surgery, they have a lower risk of burnout and realize a more-rewarding work/life balance. With predictable, manageable schedules that allow for generous time off, they can have a much more-balanced life, while their client hospital enjoys a well-rested, highly motivated and skilled emergency surgical team.

More surgical time and patient care, fewer administrative hassles

Surgicalists who join one of SAMGI’s community-based practices have the freedom to concentrate on performing surgery and taking care of patients, while SAMGI handles the administrative details. For most surgeons who sign on to the surgicalist model, the opportunity to focus exclusively on surgery and related patient care is a game-changing benefit that boosts professional satisfaction by getting surgeons back to their passion.

SAMGI surgicalists recognize the value of our mission, evidence-based processes and support system, demonstrated by SAMGI’s surgeon-retention rate of 97.9% year over year…among the highest in the nation and the kind of stability and predictability our clients need and have come to expect.

Dedicated to quality standards and outcomes

With quality at the core of our shared mission, SAMGI surgicalists are motivated to make a significant professional contribution in one of our community-based practices. Our surgicalists serve on and are supported by teams of other highly qualified clinical professionals of experienced surgeons, nurse practitioners and physician assistants. Together, we provide services according to evidence-based medical protocols to help ensure smooth handoffs and the highest quality of surgical care.

Learn what SAMGI can do for your facility

Founded and managed by surgeons, SAMGI is setting the standard for surgicalist performance. We’re transforming the face of emergency surgical care with the integrated surgical coverage solutions hospitals need to succeed today. Our dedicated, highly trained, board-certified surgeon-led teams are on-duty 24/7/365 to deliver services from admission through convalescence, while our seamless program management helps ensure the highest performance. In fact, our proven, turnkey approach has earned peer-reviewed ROI while helping optimize performance, efficiency, revenues and — most important — quality of care and clinical outcomes.

Let’s talk about how we can help you meet your hospital’s emergency surgical performance needs. Email us at info@samgi.com or call (877) 440-9693.