Hospital Impact – April 14, 2016
by Leon Owens
Finding a general surgeon to be on-call for the emergency department (ED) is becoming increasingly difficult. A 2011 Robert Wood Johnson Foundation survey found that 75 percent of EDs had inadequate surgical call coverage, and estimates are that it is only going to get worse with ongoing shortages of qualified surgeons.
Not only do such shortages have the potential to impact patient care and already over-burdened ED staff, they also compound the challenges hospitals face in today’s era of value-based purchasing (i.e. meeting requirements for achieving high-quality surgical care, reducing complications and meeting pay-for-performance goals).
In response to these challenges, the acute care surgery model has emerged. It applies trauma surgery standards to emergency general surgery patients to reduce the time non-trauma ED patients have to wait for a surgeon.
Here are some reasons why hospital administrators are taking a new look at how they provide coverage for emergency general surgery:
EDs are crowded with more patients than ever before. When patients need surgery and surgeons aren’t available, there are delays, complications, unhappy patients and families, and unnecessary expenses.
Increasingly, surgeons in private practice are reluctant to be on call for emergency surgeries—creating administrative hassles and tension between hospital administrators and the medical staff.
The traditional on-call method of handling emergency surgeries works against hospitals’ mandate to collaborate with physicians to deliver standardized care according to best practices. It is not possible to achieve this collaboration without cohesive teams of practitioners who are aligned with the hospital to achieve these common goals…