Category: Improved Outcomes

Acute Care Surgery, Quality of Care, Surgical Hospitalist Results

Acute Care Surgical Programs: Expanding Surgical Care

As hospitals continue to deal with pay-for-performance, accountable care and population health management, it’s vitally important for them to consider how emergency surgery services are delivered and how it impacts their success.

One new resource on this topic is an article I recently wrote for the inaugural issue of Management in Healthcare, a new peer-reviewed journal. The article examines how, by implementing the service model developed for trauma and applied to emergency surgeries, it is possible for hospital’s most at-risk patient groups to receive standardized care according to best practices and practice management guidelines 24/7.

The result: high-quality care and better performance outcomes for the hospital. Plus, continuous quality improvement initiatives that touch multiple hospital departments, raising the bar on performance throughout the facility.

This new model for acute care surgery, also referred to as surgicalist programs, can help hospitals achieve results, as well as enhance their competitive position. Metrics show that a well-structured surgical hospitalist program can improve patient outcomes and improve costs. For example, a July 2014 paper in the Journal of the American College of Surgeons highlighted how a surgical hospitalist program produced sustainable results, including a 31% reduction in hospital costs and complications declined by 43%.

Read the article here.

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