Surgicalists: The Cutting Edge

Acute Care Surgery, Quality of Care, Surgical Hospitalist Results

Data Shows the Acute Care Surgery Model Improves General Emergency Surgery Outcomes

samg_docs-patientOur Acute Care Surgery Model (also referred to as surgical hospitalist or surgicalist programs) delivers a programmatic approach to general emergency surgery providing access to high quality emergency surgical care 24/7. By applying the acute care surgery model, which applies disciplines in trauma surgery to general surgery, we are able to achieve consistent, evidence-based care and improved clinical outcomes for our patients. Our comprehensive Acute Care Surgery program delivers a dedicated team of surgeons led by a medical director whose sole practice is treating emergency surgery patients. This model improves efficiencies throughout the hospital but more importantly improves patient outcomes.

We found that after implementing our Acute Care Surgery Model, complications were dramatically decreased. Results of a five-year study published in the Journal of the American College of Surgeons showed:

  • Complications decreased 43%
  • Length of stay decreased 12%
  • Hospital costs decreased 31%
  • Readmission rates were down—while LOS significantly decreased, readmissions did not increase
  • Overall hospital CMI improved
  • Annual savings was $2 million

Additionally, this model produced shorter lengths of stay and lower costs.

  • Appendectomies—an average 27.8% decrease in total hospital costs; average LOS decreased 36.7%; the number of appendectomies increased 15.8%
  • Laparotomies—outcomes from in-hospital morbidity declined 49%
  • Cholecystectomies— in-hospital morbidity declined 83%; an average 14% decrease in total hospital costs; the readmission rate decreased 69.6%; number of cholecystectomies increased 29.8%

Another study reported that the national average cost for cholecystectomies per case is $15,6501, yet after the Acute Care Surgery model was applied at the facility referenced above, its cost per case for the same procedure was $8,432, representing a 46% savings.

These results, which have proven sustainable and can be implemented in all types of hospitals, are an outcome of improving timeliness of care, implementing patient care guidelines and protocols to reduce variation. For more information, visit our Our Program page.

1 Stey A, Brook R, Needleman J, et al. Hospital Costs by Inpatient. J Am Coll Sug 2015:220:207-217

Careers, Surgical Hospitalist Program

A Formula for Work-Life Balance: Surgical Hospitalist

Dr Mitchell and Sundance McGuirre RNHospitals are searching for a workable system for 24/7 ED emergency surgery coverage. Unfortunately for the hospitals, there’s a shortage of surgeons. This, combined with many surgeons’ frustration with ED call coverage and their desire to have more regular hours, is exacerbating the problem. It’s often a major source of conflict between hospital administrators and surgeons, which can potentially negatively impact quality of care.

That’s one of the reasons Surgical Affiliates was founded: to be the solution for this problem. Our surgicalist model delivers proven, high-quality, 24/7 coverage for patients needing emergency surgeries, while offering healthcare professionals (surgeons, NPs and PAs) an option they never thought was possible: having a challenging and rewarding career AND time for personal priorities. In addition to general surgery, our program encompasses specialties such as trauma, and orthopedic surgery.

Here are a few reasons to consider becoming a member of the Surgical Affiliates team:

  • You can be part of a new and satisfying field as a surgicalist.
  • You can be in a practice unlike any you’ve known, with the professional satisfaction of doing what you were trained to do.
  • You can focus on your patients while all of the management services are handled for you.
  • You can have dependable and regular schedules that afford you the time and benefits to attain work-life balance.
  • You can enjoy your free time with the security of knowing that your patients are receiving the highest quality of care from your practice partners who are as committed to quality patient care as you are.

The career and lifestyle afforded by our model is what enables us to bring teams of high quality and talented healthcare personnel to our partner hospitals. When we look for healthcare professionals to join our team, in addition to the usual criteria of board certifications, etc., we seek out people who are passionate about their job and the patients’ well-being, who have a record of achieving high patient satisfaction scores, who are involved in their community and who thrive on working in a team-oriented environment. We look for top people because we want the doctors in our partner hospitals to say they “want their family members to be treated by our doctors.”

For surgeons especially, Surgical Affiliates’ model offers more options. For example, the surgeon who may be thinking of retiring may re-consider with the option of a more flexible schedule on the surgical hospitalist team, or a private practice without the stress of taking ED call. Younger surgeons may thrive on the challenge of doing emergency surgeries while not worrying about patient insurance or billing, and enjoying the lengthier blocks of free time for family or other pursuits.

We are always looking for:

  • General surgeons
  • Trauma surgeons
  • Orthopedic surgeons
  • Nurse practitioners
  • Physician assistants

Why not join us and be part of a team that is transforming surgical care across the U.S.? Here’s a link so you can learn more: https://www.samgi.com/for-providers/

Case Studies, Quality of Care, Surgical Hospitalist Results

Driving Hospital Success with a Level II Trauma Center

Trauma photo for MSJ BlogHospitals with trauma centers have a demonstrated commitment to providing the absolute best care possible. They do this by meeting the requirements established by the government and other authorized entities. Many take the additional step of voluntarily allowing experts from the American College of Surgeons (ACS) to conduct an on-site review of the hospital to assess and verify the required, relevant program features, including items such as hospital policy, resources and patient care.

Designed to help hospitals improve their trauma care, ACS verification is, as you can imagine, a complicated process. Many hospitals view the process as an overwhelming task and opt not to go forward. However, we have personally seen that the benefits to patients, the community and the hospital make the process a worthwhile endeavor.

In fact, we just developed a case study about the hospital-wide improvements in operational and financial benefits achieved by Mercy San Juan Medical Center when it undertook the mission to develop a trauma center. Once the hospital made the decision to develop a trauma center to improve the care to its community, hospital administration partnered with us (Surgical Affiliates) to develop a Level II trauma center, which we developed from the ground up based on ACS guidelines so that no recommendations for improvement could be made by the certification team from the American College of Surgeons.

Since its opening, the Level II trauma center at Mercy San Juan Medical Center has proven to be a driver of success for the hospital. Over time, it has consistently increased volume growing from treating 750 trauma patients in 2001 to 1,991 patients in 2014. Additionally, due to our culture of yes, we increased the number of patient transfers in to the hospital per year; from 55 in 2011, to 254 in 2014. We found the “transfer in” population and the ability of getting out-of-network and capitated patients repatriated to their “home” systems when their conditions stabilized improved the hospital payer mix.

What’s more, the presence of the trauma center led to the creation of an environment that allowed for open and honest peer review with a commitment to closing loops and changing behavior. It also created a “halo effect” throughout the hospital, resulting in improved performance across multiple departments. For example, faster turn-around times for lab work, the institution of a massive transfusion protocol so that blood transfusions were available within 120 seconds of the patient’s arrival, rapid MRI and CT scan availability, and a myriad of other enhancements.

Our collaboration with the hospital also sparked the idea for a revolutionary approach to acute surgical care: the Surgical Affiliates’ System of Care©, which adapts and modifies trauma care standards to the emergency general surgery model or acute care surgery. Those standards include: board certified surgeons, an interdisciplinary approach, team cohesiveness, specific and measured responsiveness, a standardized approach to care by all providers, and peer review of all cases to identify performance improvement opportunities.

As a result of its trauma program collaboration with Surgical Affiliates, Mercy San Juan implemented a surgical hospitalist program with us to enhance its acute care surgery services. The hospital is now seeing the results in shorter lengths of stay, fewer complications and the ability to capture a larger demographic.

The Mercy San Juan Level II trauma center is an outstanding example of hospital/physician collaboration. If you’re interested in learning more, please read our new case study. You can request a copy by visiting https://www.samgi.com and clicking on the box entitled “Transformational Hospital/Physician Collaboration Prepares to Strike Twice.”