Surgicalists: The Cutting Edge

Surgicalist Programs

Top 5 Reasons to Launch a Surgicalist Program at Your Hospital

The importance of on-call surgeons for management of emergency care cases is undeniable; however, the sole dependence upon the on-call approach in today’s care setting is quickly becoming unreliable. Increased on-call burdens, irregular and hectic workloads, and decreased work-life balance have contributed to the surgeon shortages observed in many hospitals today. A Surgicalist approach is the answer to this growing crisis.

The Top 5 Reasons to Launch a Surgicalist Program

Currently, there is a slow but steadily rising trend emerging in hospitals across the country, one that utilizes a Surgicalist strategy for improving hospital outcomes and lowering staff turnover. Surgicalists manage emergency surgeries exclusively, reducing the need for relying solely on on-call surgeons to cover planned interventions.

Perhaps the most beneficial reasons for implementing a Surgicalist strategy includes reducing the on-call burden for surgeons, improving the achievement of greater annual financial goals, introducing new surgical skill sets, and improving patient-related outcomes.

Reason #1: Improved Surgeon Retention

Finding consistent medical care for acute care surgery patients is a growing challenge that seems to be gaining momentum. A nationwide surgeon shortage as well as surgeons’ evolving priorities have reduced the number of on-call doctors available for emergency surgical needs. Many surgeons, for example, are seeking a greater work-life balance and are opting for private practice.

A Surgicalist program may be the answer to the quickly deteriorating viability of surgical call rotation. Surgicalists eliminate the burden of unmanageable workloads, allowing hospital surgeons to focus on more private and elective surgical procedures. Potentially, employing a Surgicalist team may help reduce staff turnover while improving the quality of care offered to patients.

Reason #2: Diversify Skills

When employing a staff of Surgicalists who specialize in emergency care, you bring forth a greater range of skill and technique to the surgery floor. A traditional management approach of emergency cases involves patients receiving surgeons who are on call, yet this doesn’t mean the surgeon has a skill set that is sophisticated or experienced enough to handle every emergency patient. Surgicalists, however, are dedicated to emergency care cases. “If you crash your car, you don’t get to pick who your surgeon’s going to be,” says Lynette Scherer, MD, FACS, Chief Medical Officer of Surgical Affiliates. “We think that if you’re going to go to a trauma center, you really should get the best there is.”

Reason #3: Financial Benefit

Although hospitals do make an initial investment when implementing a Surgicalist program, the long-term cost benefit can be substantial. Simply, with more surgeons on staff to handle both elective and emergency interventions, hospitals experience a lower patient transfer rate. Retaining patients equates to more surgeries, which ultimately results in more jobs and a greater net financial benefit. Additionally, there is an elimination (or drastic reduction) in call coverage stipends, resulting in greater cost savings.

Reason #4: Improve Patient Outcomes

Under a Surgicalist program, patients often experience shorter wait times, shorter length of hospital stay, and fewer treatment-related complications. Typically, improved patient outcomes are a benefit associated with early or immediate intervention, compared with intervention that depends upon an on-call surgeon’s own schedule and availability. Surgicalists, in comparison, are available 24/7, with no competition between elective and emergency cases.

Reason #5: Gain (or Improve) Community Trust

When a hospital can handle more patients and improve the level of care they provide for emergency cases, they begin to strengthen the trust their community has for them. In turn, this may result in a greater number of patients arriving to the center to receive much-needed care, regardless of the type of treatment they receive.

“Our community knows that they can count on us–we’re there in any emergency,” says Gary J. Passama, President and Chief Executive Officer of North Bay Healthcare System, a hospital that has recently implemented a Surgicalist program. “The team collaborating with our hospital staff,” he adds, “has improved patient care with the consistent use of surgical-best practices, continuity of care, and communications with patients, families, and the patient’s primary care team.”

Considering a Surgicalist Program?

Of hospitals that feature a traditional approach to emergency cases, only about 2% have Surgicalist programs in place. Part of the reason why these programs are so rare involves the lack of awareness and education around Surgicalist teams. To learn more about the Surgicalist approach and how you can use it to gain a competitive advantage over traditional hospital systems, contact us for a free program analysis consultation today.

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Surgicalist Programs

Why Surgicalist Programs Are the Future of Emergency Acute Care

There is a growing trend among practicing surgeons to seek a greater work-life balance, and many surgeons are moving away from private practice to avoid the strenuous and stressful regimen of constantly being on-call. This, along with uncompensated care, declining reimbursement, and liability issues, are contributing to an unprecedented shortage of on-call surgeons performing emergency care. Unsurprisingly, hospitals are in need of a comprehensive strategy that will help them keep up with ever-increasing patient demands.

Currently, there is a significant need for innovative plans of action that will help not only manage emergency surgical care and potentially improve patient outcomes, but will also facilitate greater improvements within the hospital system overall. A surgicalist model addresses these needs, providing 24/7 dedicated local emergency surgeons for immediate emergency general surgery and trauma care, or even orthopedic surgery. The implementation of such an approach is aimed toward making a difference every day in the lives of patients.

The Role of a Surgicalist in Future Care

Although a traditional hospitalist model can be viable in certain care settings, the adoption of a surgicalist strategy can provide specific advantages in patient care and hospital-specific outcomes, as evidenced by numerous hospital case studies throughout the United States. Shorter wait times, reduced length of stay (LOS), fewer complications, and lower rates of patient transfers represent some of the reasons why a surgicalist model will advance emergency care now and in the future.

Improved Patient Care

The quality of patient care in emergency surgery continues to be a big priority for hospitals across the country. A 5-year study with Sutter Medical Center, Sacramento, showed noticeable benefits related to the surgicalist model for improving patient outcomes. After partnering with Surgical Affiliates and incorporating the surgicalist program in their center, overall patient complications were down by 43% and LOS decreased from 6.5 to 5.7 days.

Surgicalist programs may also increase the amount of trauma surgeries performed annually, thereby increasing practice experience among surgeons. Greater experience often translates into more knowledgeable surgeons and a higher quality of care. At NorthBay Medical Center in Fairfield, California, for example, trauma surgeries increased by 3.5% in 2014 compared with 2012.

Greater Employee Retention

Compared with a traditional model of care, the surgicalist strategy reduces the need for surgeons to juggle both on-call and elective practices. When surgeons have a greater work-life balance and a clearer focus on what’s required of them (i.e., surgeries that they were trained to do), their quality of life improves. At Memorial Hospital Los Banos in central California, the implementation of a surgicalist program resulted in a significant improvement in its employee turnover rate, likely mirroring the greater workflow efficiency and higher physician satisfaction accomplished by their new surgicalist program.

Hospital Cost Savings

A surgicalist model may also help reduce costs as well as contribute to a hospital’s overall fiscal goals. For example, a surgicalist program may reduce rates of patient transfers to other facilities, which can help drive greater financial benefits to the hospital. At NorthBay Medical Center, the expanded trauma efforts by the surgicalist program was associated with an 81% reduction in transfers in 2014 compared with 2012.

Hospitals Stay Ahead of the Curve with a Surgicalist Program

The movement toward round-the-clock emergency care with highly trained surgicalists represents the changing landscape of healthcare. Millions of patients who require trauma or emergency general surgical care—particularly those admitted to rural area hospitals—have limited access to a qualified surgeon. The adoption and application of a surgicalist program helps hospitals stay ahead of their competition, leading the way toward improving patient care in the emergency setting and making a difference in the lives of patients every day.

Surgical Affiliates and the Surgicalist Approach

Surgical Affiliates Management Group is committed to making a positive difference every day in the lives of patients seeking emergency surgical care. They are the first and only organization with proven results demonstrating their ability to lower hospital costs, decrease rates of readmissions, and improve the care of patients. To learn more about Surgical Affiliates and their efforts toward providing permanent surgicalist programs in hospitals around the country, read about the Surgical Affiliates System of Care©.

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Orthopedics

Acute Orthopedic Surgery Programs Treat the “Ouch!” of Emergency Surgery Needs

Too often, patients with broken bones or other injuries that require the services of an orthopedic surgeon arrive at the ED only to discover these specialists aren’t available. The patient must wait for treatment, or sometimes be transferred to a facility out of their local area. The result is delayed treatment, inconvenience for both patients and families, a greater risk of complications and potentially a loss of revenue for the hospital when patients are transferred.

As a result of these challenges, orthopedic surgeons who function as acute orthopedic surgeons or orthopedic hospitalists are one of the latest trends in hospital medicine. Many surgeons find that being part of a comprehensive program that provides round-the-clock coverage and care for patients is preferable to the demands of a private practice and/or the inconvenience of taking call at the hospital. Being part of a highly qualified team of surgeons and advanced practitioners, who are embedded in the hospital 24/7 to ensure continuity of care, means that surgeons can enjoy a manageable work schedule, a professionally exciting career and competitive compensation.

For hospitals, the benefits are also compelling: the continuity and standardization that improves patient care and reduces complications, plus a team of highly qualified surgeons who are aligned with their goals to reduce unnecessary readmissions, achieve high patient satisfaction and reduce medical errors.

Pamela Mehta, MD, Surgical Affiliates Chief of Orthopedic Surgery, believes that, “The goal for every patient should be access to high quality surgical services no matter what time of day or night it’s needed. Applying acute care surgery standards to the orthopedic model can improve performance and resolve ongoing issues of reducing complications, improving outcomes, lowering costs, increasing efficiency and enhancing patient satisfaction.”

The acute orthopedic surgery program is a long-term, sustainable approach to meeting orthopedic surgery needs in a community and ensuring consistent coverage for patients needing both emergency and general orthopedic surgery. The program can be implemented as both a stand-alone and as a complement to acute care surgery and trauma programs.

What’s behind the growth of the acute orthopedic surgeon?

In short, it’s the same forces that are fueling the growth of the acute care surgery or surgicalist specialty in general:

  • Increasing reluctance of surgeons to be on-call for emergency surgeries
  • The growing shortage of ED physicians and surgeons (including orthopedic surgeons)
  • Increasing ED patient loads and an uptick in ED cases among the newly insured
  • The failure of the old model of on-call surgeons and specialists to keep up with the demand of higher quality and efficiency metrics; instead the old system can result in delays in patients getting the treatment they need, difficulties in providing standardized care, and lead to complications as well as a lack of efficiency in hospital operations

What factors go into a successful program?

An acute care surgery program, including those with acute orthopedic surgeons, must be much more than having surgeons based in the hospital. The acute orthopedic surgery program must be built upon leadership from expert surgeons and executives, outstanding surgical teams that follow evidence-based guidelines in care delivery and collaboration with the hospital staff to consistently improve patient care and safety.

When this model is in place, patients, hospitals and local orthopedic surgeons can reap the benefits of:

  • Better access for patients to this specialized care. Orthopedic surgeons are available any time of the day or night 24/7
  • Lower average length of stay for patients and as a result, lower treatment costs
  • Community orthopedic surgeons freed up from taking ED surgical calls or in-hospital consults, enabling them to increase the efficiency and volume of their private practice and elective surgery case loads
  • Orthopedic surgeons have an attractive alternative to the long hours and demands of a private practice
  • Increased market share and revenue for hospitals
  • Meeting the requirement for hospitals seeking higher level designation trauma centers, including Level I and Level II, to have trauma surgeons available that are trained in orthopedic surgery

Orthopedic surgeons who are interested in learning more, click here: https://www.samgi.com/orthopaedic-surgery/. Hospitals interested in acute orthopedic surgery programs, click here: https://www.samgi.com/for-hospitals/.

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